Continuous Positive Airway Pressure Adherence in Patients with Obstructive Sleep Apnea Syndrome

Abstract

Background and Objective: Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder with serious consequences. The best treatment for moderate to severe OSA is continuous positive airway pressure (CPAP), and is associated with reduced OSA-related adverse consequences. However, poor adherence to CPAP is still an important issue in these patients. This study aimed to evaluate CPAP adherence, and predisposing factors for poor adherence.
Materials and Methods: In this longitudinal study, 120 patients with confirmed OSAS who underwent positive airway pressure titration study were enrolled. After at least six months of CPAP therapy, the subjects were evaluated for CPAP adherence.
Results: Of 120 participants, 40 (33.3%) used CPAP device for at least 4 hours per night in 70% of nights after at least 6 months of prescription (compliant subjects). Older age was associated with more CPAP adherence (54.3 ± 11.3 vs. 49.3 ± 12.0, P = 0.037). Patients with higher prescribed device pressure were less likely to use CPAP regularly  (8.7 ± 5.4 vs. 24.3 ± 44.2, P = 0.049). Difficult breathing and discomfort with full-face mask were the most common reported problems by compliant patients.
Conclusion: Poor adherence to CPAP therapy is a serious issue in patients with OSAS. Older age and lower CPAPdevice pressure were associated with favorable adherence. More interventions should be evaluated for improving acceptance and adherence of CPAP therapy among the patients with OSAS.