No abstract

No abstract

Introduction: Continuous positive airway pressure (CPAP) remains the treatment of choice for obstructive sleep apnea (OSA). Although it is an effective treatment, adherence is poor. The literature has failed to identify treatment variables that consistently predict CPAP adherence. Methods: We performed a retrospective analysis of patients with OSA started on CPAP in our clinic over the past 7 years. We compared those who were compliant after 30 days of CPAP use with those who did not demonstrate regular use, defined as CPAP use for ≥4 hours per night on 70% of nights. We assessed several clinical and demographic variables for their relationship with CPAP adherence including self-identified race, gender, sedative-hypnotic use during the diagnostic polysomnogram, mask type and brand. Differences between the groups were determined through the Chi-square test and Fisher's Exact test. Results: Two-thousand and four patients were included in the analysis (91% men, mean age 45.2 years ±10.8, mean AHI of 19.79 ± 15.1, mean BMI of 29.49 ± 8.7). At 30 days following the initiation of CPAP therapy, overall compliance was 66%. Patients treated with a full face mask (56.6%) were significantly more compliant (68.2%) compared to those using a nasal interface (63.5%; p-value of 0.032, OR 1.2). In regards to the different mask brands, there was no statistical significance between the six separate interfaces included in the database. Selfidentified Asian patients (2%) were also more likely to be compliant (77.8%; p-value of 0.000, OR 2.9) compared to other categories of race. The use of a sedative hypnotic, eszopiclone or zolpidem, during the polysomnogram was not indicative of compliance (p-value of 0.887). Conclusion: Our study demonstrates a statistically superior CPAP compliance at 30 days amongst patients treated with full face masks. Although statistically significant, these findings are not felt to be clinically relevant. However, this contradicts previously published data that full face masks negatively affect CPAP adherence. Additional investigation is warranted to further identify treatment variables associated with improved CPAP compliance. Support (If Any)