CPAP therapy in patients with mild OSA: implementation and treatment outcome

Rosenthal, León; Gerhardstein, Rebecca; Lumley, Alicia; Guido, Peter; Day, Ryan; Syron, Mary Lou; Roth, Thomas

doi:10.1016/s1389-9457(00)00012-5

Cited by 82 publications

(53 citation statements)

References 9 publications

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“…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

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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.

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confidence: 99%

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

Somiah

Taxin

Keating

et al. 2012

Journal of Clinical Sleep Medicine

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“…[17][18][19] Use of nasal pillows as a firstline mask of choice regardless of CPAP pressures should be further investigated, as this study was unable to find any reasons why nasal pillows should not be used on high pressure patients.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Performance of Nasal Pillows at High CPAP Pressures

Zhu

Wimms

Benjafield

2013

Journal of Clinical Sleep Medicine

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“…Mask fit difficulties, discomfort, feelings of claustrophobia, and difficulty with swallowing are potentially magnified in the neuromuscular disease population. Studies in the general OSA population have shown the quantity of NPPV usage within the first 30 days (and in particular the first week) of initiation to be strongly predictive of long-term compliance [86][87][88]. Improved NPPV adherence has been associated with patient education before, during or shortly after the initiation of CPAP therapy [89,90].…”

Section: Compliancementioning

confidence: 99%