Evaluation of Compliance with Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea Syndrome
AbstractBackground and Objective: Obstructive sleep apnea syndrome (OSAS) is a breathing disorder during sleep and de-fined as unexplained sleepiness during the day, with a minimum of five obstructive respiratory events per hour of sleep. This study aimed to evaluate the compliance to continuous positive airway pressure (CPAP) in patients with OSAS.Materials and Methods: This cross-sectional study was conducted on OSAS patients whose polysomnography test was performed at least 1 year before, and CPAP was prescribed for them. Apnea–hypopnea index (AHI) and patients’ demographic information were recorded.Results: This study included 105 patients with OSAS. The mean AHI score was 40. Patients were distributed into three groups according to their AHI: Mild (5 ≤ AHI < 15): 20 patients (19%), moderate (15 ≤ AHI < 30): 25 patients (23.8%), and severe (AHI ≥ 30): 60 patients (57.1%). Patients were divided into three groups based on their use of CPAP: 27 (25.7%) patients were regular users of CPAP, their time average use was 5.4 hours a day; 11 (10.4%) patients were in the group who stop using their CPAP, their average of time use was 6.4 hours a day; and 67 (63.8%) patients were in the group who did not use the CPAP.Conclusion:The long-term adherence to CPAP in patients with OSAS was 25%, which correlated significantly with their financial situation, while there was no significant association between the use of CPAP with age, sex, educational status, and the severity of sleep apnea.
Sanders MH, Martin RJ, Pennock BE, et al. The detection of sleep apnea in the awake patient. The 'saw-tooth' sign. JAMA 1981; 245: 2414-8.
Hoffstein V, Oliver Z. Pulmonary function and sleep apnea. Sleep Breath 2003; 7: 159-65.
Yaggi HK, Concato J, Kernan WN, et al. Ob-structive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005; 353: 2034-41.
Marshall NS, Neill AM, Campbell AJ, et al. Randomised controlled crossover trial of humidified continuous positive airway pressure in mild obstructive sleep apnoea. Thorax 2005; 60: 427-32.
George CF. Perspectives on the management of insomnia in patients with chronic respiratory disorders. Sleep 2000; 23: S31-S35.
Victor LD. Treatment of obstructive sleep apnea in primary care. Am Fam Physician 2004; 69: 561-8.
Levy P, Pepin JL. Auto-CPAP: An effective and low-cost procedure in the management of OSAS? Eur Respir J 1998; 12: 753-5.
Flemons WW, Tsai W. Quality of life conse-quences of sleep-disordered breathing. J Allergy Clin Immunol 1997; 99: S750-S756.
Morgenthaler TI, Aurora RN, Brown T, et al. Practice parameters for the use of autotitrating contin-uous positive airway pressure devices for titrating pres-sures and treating adult patients with obstructive sleep apnea syndrome: An update for 2007. An American Academy of Sleep Medicine report. Sleep 2008; 31: 141-7.
Doherty LS, Kiely JL, Lawless G, et al. Impact of nasal continuous positive airway pressure therapy on the quality of life of bed partners of patients with ob-structive sleep apnea syndrome. Chest 2003; 124: 2209-14.
McEachern RC, Patel RG. Pneumopericardium associated with face-mask continuous positive airway pressure. Chest 1997; 112: 1441-3.
Souter MA, Stevenson S, Sparks B, et al. Upper airway surgery benefits patients with obstructive sleep apnoea who cannot tolerate nasal continuous positive airway pressure. J Laryngol Otol 2004; 118: 270-4.
Hoffstein V, Viner S, Mateika S, et al. Treat-ment of obstructive sleep apnea with nasal continuous positive airway pressure. Patient compliance, percep-tion of benefits, and side effects. Am Rev Respir Dis 1992; 145: 841-5.
McArdle N, Devereux G, Heidarnejad H, et al. Long-term use of CPAP therapy for sleep ap-nea/hypopnea syndrome. Am J Respir Crit Care Med 1999; 159: 1108-14.
Pepin JL, Krieger J, Rodenstein D, et al. Effec-tive compliance during the first 3 months of continuous positive airway pressure. A European prospective study of 121 patients. Am J Respir Crit Care Med 1999; 160: 1124-9.
Sin DD, Mayers I, Man GC, et al. Long-term compliance rates to continuous positive airway pres-sure in obstructive sleep apnea: A population-based study. Chest 2002; 121: 430-5.
Rauscher H, Popp W, Wanke T, et al. Ac-ceptance of CPAP therapy for sleep apnea. Chest 1991; 100: 1019-23.
Elkhouli O, Wolkove N, Baltzan M. Predictors of continuous positive airway pressure (CPAP) com-pliance and satisfaction after split-night protocol. Chest 2005; 128: 222S.
Jean WH, Boethel C, Phillips B, et al. CPAP compliance: Video education may help! Sleep Med 2005; 6: 171-4.
Simon-Tuval T, Reuveni H, Greenberg-Dotan S, et al. Low socioeconomic status is a risk factor for CPAP acceptance among adult OSAS patients requiring treatment. Sleep 2009; 32: 545-52.
Wolkove N, Baltzan M, Kamel H, et al. Long-term compliance with continuous positive airway pres-sure in patients with obstructive sleep apnea. Can Respir J 2008; 15: 365-9.
Yetkin O, Kunter E, Gunen H. CPAP compli-ance in patients with obstructive sleep apnea syndrome. Sleep Breath 2008; 12: 365-7.
Campos-Rodriguez F, Martinez-Garcia MA, Reyes-Nunez N, et al. Long-term continuous positive airway pressure compliance in females with obstructive sleep apnoea. Eur Respir J 2013; 42: 1255-62.
Somers ML, Peterson E, Sharma S, et al. Con-tinuous positive airway pressure adherence for obstruc-tive sleep apnea. ISRN Otolaryngol 2011; 2011: 943586.
Yang MC, Lin CY, Lan CC, et al. Factors af-fecting CPAP acceptance in elderly patients with ob-structive sleep apnea in Taiwan. Respir Care 2013; 58: 1504-13.
Nagarajan R, Ranganathan L, Sundaram AK, et al. CPAP therapy in OSA-A gap analysis between recom-mendation and usage. Indian J Sleep Med 2012; 7: 150-6.
Hooti MA, Jaju D, Abri M. CPAP acceptance and compliance in sleep apnea patients in Oman. Sleep Med 2013; 14: e153.