CPAP compliance in patients with obstructive sleep apnea syndrome

Yetkin, Özkan; Kunter, Erdoğan; Günen, Hakan

doi:10.1007/s11325-008-0188-4

Cited by 85 publications

(51 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In most studies, [26][27][28][29] the AHI values in the first night PSG were significantly higher in subjects who had been using CPAP/BPAP, and it was interpreted that CPAP adherence was closely related to disease severity. On the other hand, there are also studies [30][31][32] demonstrating no correlation between CPAP adherence and AHI.…”

Section: Discussionmentioning

confidence: 99%

CPAP Adherence of Patients With Obstructive Sleep Apnea

et al. 2013

View full text Add to dashboard Cite

BACKGROUND: Continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BPAP) are the gold standard treatments for obstructive sleep apnea syndrome (OSAS), but CPAP/BPAP is not well tolerated and requires long-term follow-up. OBJECTIVE: We prospectively assessed subjective and objective adherence and factors that affect adherence in OSAS patients. METHODS: Subjects using CPAP/BPAP were questioned about adverse effects of CPAP/ BPAP and were assessed with the Epworth Sleepiness Scale (ESS) at the first, third, sixth, and twelfth month, and once every 6 months after the first year. CPAP/BPAP use and objective and subjective adherence were assessed. Subjects who used CPAP/BPAP for at least 4 hours per night for at least 70% of the days monitored were regarded as adherent, and those who did not were considered non-adherent. The relationships between adherence and demographic data, polysomnography findings, ESS scores, and adverse effects were statistically analyzed. RESULTS: Sixhundred forty-eight subjects who were diagnosed with OSAS by polysomnography and accepted to use CPAP/BPAP in our sleep center between January 2005 and June 2011 were included. Fourhundred fifty-one subjects (69.6%) were men, and 197 (30.4%) were women. Two-hundred fortyeight (38.3%) subjects attended follow-ups, 246 (37.9%) were called by telephone, and 154 (23.8%) could not be reached. Of the whole population, 63.9% had obtained their CPAP/BPAP machine. In the 248 subjects who attended follow-ups, subjective adherence was 85.1% and objective adherence was 64.5%. Improvement in ESS score (P < .001) and satisfactory sleep (P < .001) were found to be significantly higher in the adherent group. Chest discomfort, difficulty falling asleep, and sleep disturbances were significantly higher in the non-adherent group (all P < .01). CONCLUSIONS: Of the whole population, just 38.3% attended follow-ups. The objective adherence was lower than the subjective adherence in subjects who attended follow-ups. Younger subjects were more adherent, and the most important factors that correlated with adherence were substantial improvement of daytime sleepiness and effect of CPAP/BPAP on satisfactory sleep. CONCLUSIONS: CPAP/ BPAP adherence should be followed with objective monitoring.

show abstract

Section: Discussionmentioning

confidence: 99%

CPAP Adherence of Patients With Obstructive Sleep Apnea

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Nonetheless many subjects find the system difficult to tolerate. 36,37 A passive wearable device such as an OA has obvious advantages.…”

mentioning

confidence: 99%

Clinical guidelines for oral appliance therapy in the treatment of snoring and obstructive sleep apnoea

et al. 2013

View full text Add to dashboard Cite

The purpose of this review is to provide guidelines for the use of oral appliances (OAs) for the treatment of snoring and obstructive sleep apnoea (OSA) in Australia. A review of the scientific literature up to June 2012 regarding the clinical use of OAs in the treatment of snoring and OSA was undertaken by a dental and medical sleep specialists team consisting of respiratory sleep physicians, an otolaryngologist, orthodontist, oral and maxillofacial surgeon and an oral medicine specialist. The recommendations are based on the most recent evidence from studies obtained from peer reviewed literature. Oral appliances can be an effective therapeutic option for the treatment of snoring and OSA across a broad range of disease severity. However, the response to therapy is variable. While a significant proportion of subjects have a near complete control of the apnoea and snoring when using an OA, a significant proportion do not respond, and others show a partial response. Measurements of baseline and treatment success should ideally be undertaken. A coordinated team approach between medical practitioner and dentist should be fostered to enhance treatment outcomes. Ongoing patient follow-up to monitor treatment efficacy, OA comfort and side effects are cardinal to long-term treatment success and OA compliance.Keywords: Mandibular advancement splint, obstructive sleep apnoea, oral appliance, review, snoring.Abbreviations and acronyms: AASM = American Academy of Sleep Medicine; ADA = Australian Dental Association; AHI = apnoeahypopnoea index; ASA = Australasian Sleep Association; BMI = body mass index; CBCT = cone beam computed tomography; CT = computed tomography; ESS = Epworth Sleepiness Scale; MAS = mandibular advancement splints; OA = oral appliances; OSA = obstructive sleep apnoea; PSG = polysomnogram; SDB = sleep disordered breathing; TMD = temporomandibular disorder; TMJ = temporomandibular joint; TRD = tongue retaining device; TSD = tongue stabilizing device; UARS = upper airway resistance syndrome; UPPP = uvulopalatopharyngoplasty.

show abstract

“…7,8 Several reviews have emphasized the need to identify patients who are at the greatest risk for non-adherence, with the goal of developing techniques to maximize overall adherence. 9,10 Studies have suggested that CPAP adherence can be correlated to characteristics of patients at baseline, such as the severity of OSAHS, [11][12][13] the level of EDS, 14 and anatomical factors (smaller nasal cross-sectional area, reduced nasal volume, and high nasal resistance 15,16 ), but the strength of these correlations has been weak. Drake et al showed that patients whose sleep effi ciency on the CPAP titration night improved most had the greatest CPAP compliance at 47 days.…”

mentioning

confidence: 99%

Sleep Quality, Short-Term and Long-Term CPAP Adherence

Somiah

Taxin

Keating

et al. 2012

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

S C I E N T I F I C I N V E S T I G A T I O N SU ntreated obstructive sleep apnea/hypopnea syndrome (OSAHS) signifi cantly affects quality of life and cardiovascular/cerebrovascular morbidities and mortality.1-4 CPAP therapy has been shown to be effective in treating sleep disordered breathing (SDB) by reducing the apnea/hypopnea index (AHI) 5 and by reducing excessive daytime somnolence (EDS). 6Despite this, CPAP acceptance and adherence are disappointingly low. A signifi cant number of patients (ranging from 30% to 80% in various studies) demonstrate an average CPAP usage of less than 4 hours per night. 7,8 Several reviews have emphasized the need to identify patients who are at the greatest risk for non-adherence, with the goal of developing techniques to maximize overall adherence. 9,10Studies have suggested that CPAP adherence can be correlated to characteristics of patients at baseline, such as the severity of OSAHS, 11-13 the level of EDS, 14 and anatomical factors (smaller nasal cross-sectional area, reduced nasal volume, and high nasal resistance 15,16 ), but the strength of these correlations has been weak. Drake et al. showed that patients whose sleep effi ciency on the CPAP titration night improved most had the greatest CPAP compliance at 47 days.17 More recently, studies using social cognitive theory 18-20 and health BRIEF SUMMARYCurrent knowledge/Study Rationale: Despite its efficacy, adherence to CPAP therapy is highly variable amongst patients with obstructive sleep apnea with large numbers of patients demonstrating inadequate adherence to CPAP. The present study is aimed at identifying early predictors of CPAP adherence from variables obtained at the time of diagnosis and titration of CPAP, thereby providing potential for early intervention. Study Impact: Our data show that better sleep quality (greater % REM) was seen in patients with higher CPAP adherence and confi rm that long term adherence was largely predicted by short term adherence. This suggests that interventions that improve sleep during or prior to the CPAP titration study may be useful in improving CPAP adherence.

show abstract

CPAP compliance in patients with obstructive sleep apnea syndrome

Cited by 85 publications

References 11 publications

CPAP Adherence of Patients With Obstructive Sleep Apnea

CPAP Adherence of Patients With Obstructive Sleep Apnea

Clinical guidelines for oral appliance therapy in the treatment of snoring and obstructive sleep apnoea

Sleep Quality, Short-Term and Long-Term CPAP Adherence

Contact Info

Product

Resources

About