Beneficial Effects of Long-Term CPAP Treatment on Sleep Quality and Blood Pressure in Adherent Subjects With Obstructive Sleep Apnea

Abstract

BACKGROUND: Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular diseases. Although CPAP is the first treatment choice for moderate-to-severe OSA, acceptance of and adherence to CPAP remain problematic. High CPAP adherence is generally defined as >4 h of use/night for >70% of the nights monitored. We investigated the long-term beneficial effects of CPAP on sleep quality and blood pressure in subjects with moderate-to-severe OSA according to high or low CPAP adherence. METHODS: We retrospectively analyzed 121 subjects with moderate-to-severe OSA from August 2008 to July 2012. These subjects were divided into 3 groups: (1) no CPAP treatment (n ‫؍‬ 29), (2) low CPAP adherence (n ‫؍‬ 28), and (3) high CPAP adherence (n ‫؍‬ 64). All subjects were followed up for at least 1 y. The 3 groups were compared regarding anthropometric and polysomnographic variables, presence of cardiovascular comorbidities, and blood pressure at baseline and at the last follow-up. RESULTS: The no-treatment group showed significant increases in oxygen desaturation index and blood pressure. The high-adherence group showed significant improvement in daytime sleepiness, apnea-hypopnea index (AHI), oxygen desaturation index, and blood pressure. Although the AHI was also significantly decreased after CPAP treatment in the lowadherence group, blood pressure remained unchanged. CONCLUSIONS: CPAP treatment had beneficial effects on both sleep quality and blood pressure only in subjects with OSA and high CPAP adherence who used CPAP for >4 h/night for >70% of nights monitored. Subjects with low CPAP adherence received beneficial effects on AHI, but not blood pressure.

Sleep Disorders Among People With Migraine: Results From the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study

“…34,35 Despite the relationship between obstructive sleep apnea and headache intensity, 11 only approximately one-third of respondents with self-reported sleep apnea had used a CPAP device in the 90 days before assessment. The acceptance of and adherence to CPAP treatment is problematic; 36 for example, the treatment has the potential to interfere in intimate relationships between couples. 37 As such, low overall adherence rates to CPAP treatment similar to those observed in our study have been reported, [36][37][38] leading to the suggestion that cognitive behavioral training and peer group support be implemented alongside CPAP treatment to improve adherence.…”

Predictors of long-term adherence to continuous positive airway pressure in patients with obstructive sleep apnoea and acute coronary syndrome

“…Thus, younger patients showed the highest non-compliance rates when having a recurrent ACS compared to patients without any previous history of ACS. A better understanding of the predictors of CPAP compliance is interesting because adherence to CPAP treatment is essential to achieving the beneficial effects of CPAP (23,24). Therefore, knowing the predictors of non-compliance may help in the development of clinical practice strategies directed towards improving adherence to treatment in groups with a high risk of poor compliance.…”

Stem/progenitor cells and obstructive sleep apnea syndrome - new insights for clinical applications

“…Adherence to CPAP treatment is still a critical and complex issue, subjected to the influence of a wide array of factors[75-79]. Poor adherence to CPAP is generally acknowledged as a major limiting factor in treating OSAS, with a negative impact on therapeutic success[80-82]. Studies conducted in the 1990s or even recently, revealed that approximately 30%-50% of OSAS patients rejected CPAP immediately, the proportion of noncompliant patients reaching 80% within a year[83-86].…”