PAP-therapy adherence in patients with obstructive sleep apnea and cardiovascular diseases

Abstract

Materials and methods. The study included 119 patients with obstructive sleep apnea (OSA) and cardiovascular diseases (CVD) who were followed up at the National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation in the period from 2012 to 2020, and have been receiving positive airway pressure (PAP) therapy (93 men, 78.2%). The median follow-up was 3.0 years [1.5; 5.0]. The adherence criteria were the following: the usage of the PAP device for at least 71% of nights a year, and at least 4 hours per night.
 Results. 64.3% of patients met the criteria for adherence to PAP therapy (use more than 4 hours/night, more than 71% of nights). The adherent patients were older (64.0 years [58.5; 68.0] versus 59.0 years [53.0; 65.0] resp., p=0.03) and had a higher apnea-hypopnea index AHI (47.7 events/h [37.5; 64.4] versus 38.2 events/h [30.4; 52.7] resp., p=0.04).
 Patients with stage III of hypertension were using a PAP device every night significantly less (3.4 h/night [1.1; 3.6] versus 6.3 h/night [5.3; 7.4] respectively, p=0.00) in comparison with patients with hypertension stages III. The adherence of patients with or without coronary artery disease (CAD) and paroxysmal atrial fibrillation (AF) did not differ. There was no significant difference in the incidence of stage III hypertension, CAD, and permanent AF between the groups of adherent and non-adherent to PAP therapy patients.
 Conclusion. 63.4% of patients with CVD were adherent to PAP therapy. Adherent patients were older and had a higher AHI. Patients with stage III hypertension were worse adherent to PAP therapy in comparison with patients with hypertension of lesser stages. The CVDs course in adherent and non-adherent patients did not differ.