Obstructive sleep apnea (OSA) is characterized as mild, moderate, or severe according to the number of respiratory disturbances per hour of sleep (RDI) as defined by the American Academy of Sleep Medicine. Continuous positive airway pressure (CPAP) is the primary treatment for sleep apnea. The column of pressure delivered to the upper airway by this device immediately eliminates the respiratory disturbances when it is applied. There is evidence from randomized controlled studies that CPAP also improves functional status, and the key manifestation of OSA, excessive daytime sleepiness, in individuals with severe OSI, i.e., RDI >30. However, there has been limited work exploring improvement in functional status in patients with less severe OSA, i.e., those with mild (RDI 5-15) or moderate (RDI 16-30) disease. The large placebo effect that has been reported in controlled studies of functional outcomes associated with OSA mandates the need for a placebo in investigations evaluating the true impact of this treatment. Results from the three randomized controlled studies in milder OSA that have examined this issue have been equivocal principally because of serious methodological limitations. It remains unclear whether CPAP treatment improves daily functioning in those with milder disease (RDI 5-30). This is a critical issue as this level of disease severity represents the largest segment of OSA and comprises 15% of the US population. Using Granger's model of functional assessment our primary aim is to determine whether functional status improves in patients with milder OSA following CPAP treatment. We will employ a randomized placebo-controlled parallel groups design using a sham-CPAP device as the placebo in a large sample manifesting significant daytime sleepiness. We will test the hypothesis that the change in functional status (measured by the Functional Outcomes of Sleep Questionnaire) after 8 weeks of treatment will be greater for patients treated with active CPAP compared to sham CPAP. Secondary aims of the study are: 1) to examine whether CPAP also improves daytime sleepiness; 2) to determine whether CPAP can reduce nocturnal blood pressure to lower the risk for stroke and hypertension linked to OSA.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
Project #
Application #
Study Section
Nursing Research Study Section (NURS)
Program Officer
Twery, Michael
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Pennsylvania
Schools of Nursing
United States
Zip Code
Morrow, Jarrett D; Cho, Michael H; Platig, John et al. (2018) Ensemble genomic analysis in human lung tissue identifies novel genes for chronic obstructive pulmonary disease. Hum Genomics 12:1
Sakornsakolpat, Phuwanat; Morrow, Jarrett D; Castaldi, Peter J et al. (2018) Integrative genomics identifies new genes associated with severe COPD and emphysema. Respir Res 19:46
Morrow, Jarrett D; Glass, Kimberly; Cho, Michael H et al. (2018) Human Lung DNA Methylation Quantitative Trait Loci Colocalize with Chronic Obstructive Pulmonary Disease Genome-Wide Association Loci. Am J Respir Crit Care Med 197:1275-1284
Sharma, Amitabh; Kitsak, Maksim; Cho, Michael H et al. (2018) Integration of Molecular Interactome and Targeted Interaction Analysis to Identify a COPD Disease Network Module. Sci Rep 8:14439
Radder, Josiah E; Gregory, Alyssa D; Leme, Adriana S et al. (2017) Variable Susceptibility to Cigarette Smoke-Induced Emphysema in 34 Inbred Strains of Mice Implicates Abi3bp in Emphysema Susceptibility. Am J Respir Cell Mol Biol 57:367-375
Busch, Robert; Hobbs, Brian D; Zhou, Jin et al. (2017) Genetic Association and Risk Scores in a Chronic Obstructive Pulmonary Disease Meta-analysis of 16,707 Subjects. Am J Respir Cell Mol Biol 57:35-46
Morrow, Jarrett D; Zhou, Xiaobo; Lao, Taotao et al. (2017) Functional interactors of three genome-wide association study genes are differentially expressed in severe chronic obstructive pulmonary disease lung tissue. Sci Rep 7:44232
Dodd, James W; Novotny, Paul; Sciurba, Frank C et al. (2015) Executive Function, Survival, and Hospitalization in Chronic Obstructive Pulmonary Disease. A Longitudinal Analysis of the National Emphysema Treatment Trial (NETT). Ann Am Thorac Soc 12:1473-81
Kaplan, Robert M; Sun, Qiankun; Ries, Andrew L (2015) Quality of well-being outcomes in the National Emphysema Treatment Trial. Chest 147:377-387
Cho, Michael H; McDonald, Merry-Lynn N; Zhou, Xiaobo et al. (2014) Risk loci for chronic obstructive pulmonary disease: a genome-wide association study and meta-analysis. Lancet Respir Med 2:214-25

Showing the most recent 10 out of 36 publications