Factors affecting CPAP compliance in patients with obstructive sleep apnea

Ender Şahin; Ceyhun Cengiz; Hakan Dağıstan; Yavuz Selim İntepe; Mustafa Murat Öztürk; İlknur Haberal Can; Bülent Çiftçi

doi:10.28982/josam.897532

Authors

Ender Şahin yozgat bozok üniversitesi https://orcid.org/0000-0002-0798-0393
Ceyhun Cengiz https://orcid.org/0000-0002-5177-2540
Hakan Dağıstan https://orcid.org/0000-0003-4717-5337
Yavuz Selim İntepe https://orcid.org/0000-0002-5697-5291
Mustafa Murat Öztürk
İlknur Haberal Can https://orcid.org/0000-0002-9944-196X
Bülent Çiftçi https://orcid.org/0000-0003-2703-3817

DOI:

https://doi.org/10.28982/josam.897532

Keywords:

Continuous positive airway pressure, Obstructive sleep apnea, Compliance, Apnea-hypopnea index

Abstract

Background/Aim: Continuous positive airway pressure (CPAP) is the most effective treatment for obstructive sleep apnea (OSA), but adequate patient compliance is required for treatment to achieve clinical success. This study aimed to determine factors affecting compliance with CPAP therapy in patients with OSA. Methods: In this retrospective cohort study, the records of patients that started CPAP treatment due to OSA between January 1, 2018 and August 30, 2020 were reviewed. The patients were divided into two groups based on their CPAP compliance: Group 1 included those who used CPAP regularly, and Group 2 included irregular users. Parameters such as age, gender, body mass index, apnea-hypopnea index, and educational status were compared between the groups. Results: Baseline apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) of patients using CPAP regularly were higher than irregular users (P=0.003, P=0.045, respectively). There was no significant difference between the groups in terms of age, gender, and body mass index (P=0.542, P=0.120 and P=0.796, respectively). In multivariate logistic regression analysis, low AHI, low ODI and low educational level were independent risk factors affecting CPAP compliance (P=0.010, P=0.016 and P=0.047, respectively). Conclusion: According to the results of this study, low AHI and ODI levels and low education status were risk factors for non-compliance with CPAP treatment. Therefore, patients with these features may require closer follow-up for early identification of CPAP treatment failure due to non-compliance.

Downloads

Download data is not yet available.

References

Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleeP-disordered breathing in adults. Am J Epidemiol. 2013;177:1006–14.

Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, et al. Prevalence of sleeP-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med. 2015;3:310–8.

Jennum P, Hein HO, Suadicani P, Gyntelberg F. Cardiovascular risk factors in snorers. A cross-sectional study of 3,323 men aged 54 to 74 years: the Copenhagen male study. Chest. 1992;102:1371–6.

Garbarino S. Excessive daytime sleepiness in obstructive sleep apnea: implications for driving licenses. Sleep Breath. 2020;24:37-47.

Nick AA, Catcheside P, Buchan C, Hensley M, Naughton TM, Rowland S, et al. The effect of CPAP in normalizing daytime sleepiness, quality of life, and neurocognitive function in patients with moderate to severe OSA. Sleep. 2011;34:111-9.

Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365:1046-53.

Giles TL, Lasserson TJ, Smith BH, White J, Wright J, Cates CJ. Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev. 2006;3:CD001106.

Weaver TE, Maislin G, Dinges DF, Bloxham T, George CF, Greenberg H, et al. Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep. 2007;30:711-9.

Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc. 2008;5:173–8.

Morgenthaler TI, Aurora RN, Brown T, Zak R, Cathy Alessi C, Brian Boehlecke B, et al. Practice parameters for the use of autotitrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome: an update for 2007. An American Academy of Sleep Medicine report. Sleep. 2008;31:141–7.

Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc. 2008;5:173–8.

Lee CHK, Leow LC, Song PR, Li H, Ong TH. Acceptance and adherence to continuous positive airway pressure therapy in patients with Obstructive Sleep Apnea (OSA) in a Southeast Asian privately funded healthcare system. Sleep Sci Jun. 2017;10:57–63.

Al-Abri MA, Al-Harmeli A, Al-Habsi M, Jaju D. Acceptance and Compliance of Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea: Local Population Survey. Oman Medical Journal. 2020;35:198.

Engleman HM, Martin SE, Douglas NJ. Compliance with CPAP therapy in patients with the sleep apnoea/hypopnoea syndrome. Thorax. 1994;49:263–6.

Joo MJ, Herdegen JJ. Sleep apnea in an urban public hospital: assessment of severity and treatment adherence. J Clin Sleep Med. 2007;3:285–8.

Yetkin O, Kunter E, Gunen H. CPAP compliance in patients with obstructive sleep apnea syndrome. Sleep Breath. 2008;12:365–7.

Kohler M, Smith D, Tippett V, Stradling JR. Predictors of long-term compliance with continuous positive airway pressure. Thorax. 2010;65:829-32.

Riachy M, Najem S, Iskandar M, Choucair J, Ibrahim I, Juvelikian G. Factors predicting CPAP adherence in obstructive sleep apnea syndrome. Sleep Breath. 2017;21:295-302.

Simon TT, Reuveni H, Greenberg DS, Oksenberg A, Tal A, Tarasiuk A. Low socioeconomic status is a risk factor for CPAP acceptance among adult OSAS patients requiring treatment. Sleep. 2009;32:545–52.

Tarasiuk A, Reznor G, Greenberg-Dotan S, Reuveni H. Financial incentive increases CPAP acceptance in patients from low socioeconomic background. PLoS One. 2012;7:e33178.

McArdle N, Devereux G, Heidarnejad H, et al. Long-term use of CPAP therapy

for sleep apnea/hypopnea