Long-term Compliance with Nasal Continuous Positive Airway Pressure Therapy of Obstructive Sleep Apnea

Waldhorn, Richard; Herrick, Timothy W.; Nguyen, Mai Chi; O’Donnell, Anne E.; Sodero, Jorge; Potolicchio, Samuel J.

doi:10.1378/chest.97.1.33

Cited by 244 publications

(139 citation statements)

References 9 publications

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“…The compliance, deWned as nCPAP use for minimally 4 h during Wve nights per week, in the remaining 174 patients in our series, was 79% (82.1% for Wxed pressure CPAP vs. 77.1% for auto-CPAP) as compared to earlier reported data, ranging from 46 to 89%. [10][11][12][13][14][15][16][17][18][19][20][21][22][23] Overall, only 59.5% of cases were successful, taking the non-compliant cases and the 58 (25%) failures together. Although it was to be expected that patients with a higher AHI and ESS and lower required pressure would be more compliant, no diVerence was found.…”

Section: Discussionmentioning

confidence: 99%

“…[15] When looking back at 2 decades (1986-now) [10][11][12][13][14][15][16][17][18][19][20][21][22][23] of all reported series on nCPAP use, the conclusion is that in spite of many improvements in the machinery, adjustment, intensive support, and all attempts (positive reinforcement, psychological/educational interventions, heated humidiWcation) to increase compliance otherwise, the overall compliance has only improved marginally, if at all.…”

Section: Discussionmentioning

confidence: 99%

“…A vast body of literature was published in the last two decades on the subject of (long-term) compliance of nCPAP. [10][11][12][13][14][15][16][17][18][19][20][21][22][23] Improvements in nCPAP technology, in particular the introduction of automatic adjustments of the nCPAP pressure throughout the night (auto-CPAP), [24][25][26][27][28][29] and other attempts to enhance acceptance and compliance (positive reinforcement, psychological/educational interventions, heated humidiWcation) have been introduced. [30][31][32][33][34] We were interested to see if these actions have led to better acceptance, adherence and long-term compliance as compared to earlier reported data.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acceptance and long-term compliance of nCPAP in obstructive sleep apnea

Richard

Venker

Herder

et al. 2007

Eur Arch Otorhinolaryngol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acceptance and long-term compliance of nCPAP in obstructive sleep apnea

Richard

Venker

Herder

et al. 2007

Eur Arch Otorhinolaryngol

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“…Pretreatment Epworth score and other measures of subjective daytime sleepiness are established predictors of CPAP compliance [12,22,23]. The reason that a short diagnostic TST leads to better long-term use may be because this allows a longer time for CPAP titration, which may lead to a more accurate CPAP determination [24].…”

Section: Discussionmentioning

confidence: 99%

Split-night versus full-night studies for sleep apnoea/hypopnoea syndrome

McArdle¹,

Grove²,

Devereux³

et al. 2000

Eur Respir J

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Investigation and treatment of sleep apnoea/hypopnoea syndrome (SAHS) is placing increasing demands on healthcare resources. This workload may be reduced by using split-night studies instead of the standard full-nights of diagnostic polysomnography and continuous positive airway pressure (CPAP) titration. Splitnight studies involve polysomnography in the first half of the night followed, if there is an abnormal frequency of apnoeas and hypopneas, by CPAP titration for the remainder of the night.The authors' database of all patients prescribed a CPAP trial 1991±1997 was used to compare long-term outcomes in all 49 (46 accepting CPAP) patients prescribed split-night studies with those in full-night patients, matched 1:2 using an apnoea/ hypopnoea index (AHI) of 15% and Epworth score of 3 units.Classical symptoms of SAHS were the main reason for the split-night studies (n=27). There were no differences between the groups in long-term CPAP use, median nightly CPAP use (split-night 6.0 h . night -1 , interquartile range (IQR) 3.8±7.4, fullnight; 6.2 h . night -1 , IQR 3.7±7.0, p=0.9), post-treatment Epworth scores and frequency of nursing interventions/clinic visits required. The median time from referral to treatment was less for the split-night patients (13 months, IQR 11±20 months) than for full-night patients (22 months, IQR 12±34 months; p=0.003).Split-night studies, in selected patients, result in equivalent long-term continuous positive airway pressure use to full-night studies with shorter treatment times and less healthcare utilization. Eur Respir J 2000; 15: 670±675. Sleep apnoea/hypopnoea syndrome (SAHS) is a common condition, affecting 2±4% of the middle-aged population [1]. The consequences of SAHS include daytime sleepiness, altered mood and impaired cognitive function [2,3] leading to reduced quality of life [4,5] and an increased risk of accidents at work and on the road [6±8]. Many sleep centres are struggling to cope with the number of patients being referred and the financial restrictions placed on their investigation. One way of reducing the time taken to investigate and treat patients is to use splitnight studies whereby diagnostic polysomnography and continuous positive airway pressure (CPAP) titration are accomplished on the same night rather than the standard two nights consisting of a diagnostic polysomnography night and subsequent CPAP titration night (full-night patients).Despite the potential savings, split-night studies are not widely used in all countries, at least partly because of concerns about the unknown long-term outcome of these studies [9]. The few evaluations that have included clinically relevant outcomes have not used a control group [10], or, when a control group was used, the numbers were small (n=12, in each group) and the outcome evaluation was limited to mean nightly CPAP use at the initial clinic visit [11]. Therefore, a larger scale study of the value of split-night studies was performed. MethodsUsing the authors' database of 1,211 patients booked for CPAP tit...

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“…This low compliance rate is due to many associated complications such as nasal dryness and congestion, sinus discomfort, massive epistaxis, skin rash and conjunctivitis from air leak. These complications plus the physical discomfort, noise and difficult transporting the unit lowers the CPAP tolerance [33,34].…”

Section: Mildmentioning

confidence: 99%

Telegnathic Surgery for Obstructive Sleep Apnea

Ameen¹

2015

A Textbook of Advanced Oral and Maxillofacial Surgery Volume 2

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Long-term Compliance with Nasal Continuous Positive Airway Pressure Therapy of Obstructive Sleep Apnea

Cited by 244 publications

References 9 publications

Acceptance and long-term compliance of nCPAP in obstructive sleep apnea

Acceptance and long-term compliance of nCPAP in obstructive sleep apnea

Split-night versus full-night studies for sleep apnoea/hypopnoea syndrome

Telegnathic Surgery for Obstructive Sleep Apnea

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