Compliance with continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea among privately paying patients- a cross sectional study

Abstract

BackgroundTo evaluate the compliance, benefits and side effects associated with continuous positive airway pressure (CPAP) therapy among Pakistani patients treated for obstructive sleep apnea (OSA) in private sector.MethodsPatients diagnosed to have OSA based on overnight study who were recommended for CPAP therapy, between 1998 and 2003, were evaluated by telephonic survey and review of hospital notes. Compliance, benefits and side effects associated with CPAP therapy were assessed.ResultsOut of 135 patients who were prescribed CPAP therapy, 75 could be contacted. Sixty (80%) started using CPAP within one month of diagnosis and 46 (61%) continued to use it long-term (beyond one year). Compliance with CPAP therapy was associated with higher body mass index, higher Epworth sleepiness scale score, history of witnessed apnea, and reduction in daytime sleepiness with CPAP therapy. OSA severity as assessed by apnea-hypopnea index did not affect compliance with CPAP therapy. Use of anti-depressants and CPAP induced sleep disturbances were associated with poor compliance with CPAP therapy.ConclusionsObesity, excessive daytime sleepiness, witnessed apnea and improvement of daytime symptoms following use of CPAP were predictors of improved compliance. Use of antidepressants and CPAP induced sleep disturbances were predictors of poor compliance.

Long-term prediction of adherence to continuous positive air pressure therapy for the treatment of moderate/severe obstructive sleep apnea syndrome

“…In fact, in a short-term study of 59 patients (42 men) with metabolic syndrome and OSA, mask leak was the only independent predictor of CPAP compliance at the 8-week follow-up visit [25]. Moreover, in another study of 60 patients who were recommended CPAP therapy, one-year compliance was associated with higher body mass index, higher Epworth sleepiness scale score, history of witnessed apnea, and reduction in daytime sleepiness with CPAP therapy, while OSAS severity was not associated [26]. In conclusion, based on the above data, it is difficult to conclude that the severity of OSA at the initial sleep study always predicts long-term use of CPAP.…”

Management of continuous positive airway pressure treatment compliance using telemonitoring in obstructive sleep apnoea

“…Although published evidence shows that CPAP is a highly effective therapy, a significant proportion of patients (up to 36%) underuse or even discontinue CPAP [14][15][16], mostly because of treatment-related side-effects (e.g. pressure intolerance, claustrophobia, mask displacement and machine noise) [17] and lack of improvement in symptoms.…”

Continuous Positive Airway Pressure Therapy Can Prevent Pulmonary Atelectasis after Laparoscopic Roux-en-Y Gastric Bypass Surgery in Obese Patients

“…Compliance with CPAP therapy has been reported to range from 46.6 to 86% [26][27][28][29][30], and thus, compliance with CPAP, which was not evaluated in the present study, may have affected our results. Actually, 4 of the 6 patients (66.7%) that refused CPAP developed atelectasis.…”