Long-term compliance with continuous positive airway pressure in Saudi patients with obstructive sleep apnea

Abstract

Objectives:To evaluate continuous positive airway pressure (CPAP) compliance and define predictors of CPAP compliance among Saudi patients with obstructive sleep apnea (OSA) after applying an educational program.Methods:This prospective cohort study included consecutive patients diagnosed to have OSA based on polysomnography between January 2012 and January 2014 in King Saud University, Riyadh, Kingdom of Saudi Arabia. All patients had educational sessions on OSA and CPAP therapy before sleep study, and formal hands-on training on CPAP machines on day one, day 7, and day 14 after diagnosis. The follow-up in the clinic was carried out at one, 4, and 10 months after initiating CPAP therapy. Continuous positive airway pressure compliance was assessed objectively. Logistic regression model was used to assess the predictors of CPAP adherence.Results:The study comprised 156 patients with a mean age of 51.9±12.1 years, body mass index of 38.4±10.6 kg/m2, and apnea hypopnea index of 63.7±39.3 events/hour. All patients were using CPAP at month one, 89.7% at month 4, and 83% at month 10. The persistence of CPAP-related side effects and comorbid bronchial asthma remained as independent predictors of CPAP compliance at the end of the study.Conclusion:With intensive education, support, and close monitoring, more than 80% of Saudi patients with OSA continued to use CPAP after 10 months of initiating CPAP therapy.

Long-term adherence to continuous positive airway pressure in patients with rapid eye movement-only obstructive sleep apnea: a prospective cohort study

“…Our study is the first study to report long-term adherence data in patients with REM-only OSA who had undergone an educational program and had been closely monitored. CPAP adherence among patients with REMonly OSA was lower than patients with non-stage specific OSA at months 1 and 6 and was lower than previously published adherence data in Saudi patients with general OSA (26). However, there was no difference in adherence between the two groups at 12 months ( Table 3).…”

“…The study shows that more than 80% of patients with REM-only OSA were still using CPAP at the end of the study. However, at the end of the study, the average nightly use of CPAP was 3.8 hours/night, which does not cover the whole nocturnal sleep period (26). Moreover, as REM sleep increases in the early morning hours, using CPAP only for 4 hours is insufficient (10).…”

“…A data entry form that included commonly faced side effects such as mask discomfort, intolerance and claustrophobia, nasal congestion or dryness, nasal bridge redness or ulceration, gastric distension, eye discomfort or irritation, air leak, air hunger and noisy machine was completed (26). Data were collected during each visit.…”

The Effect of Upper Airway Surgery on Continuous Positive Airway Pressure Levels and Adherence: A Systematic Review and Meta-Analysis

“…It is estimated that up to 15% of patients discontinue CPAP after their first-night trial [10]. Other recent studies demonstrate that even with intensive support, education, and follow-up, CPAP use drops to 80% within the first 10 months [11]. Reasons for poor adherence include nasal resistance and congestion, sinus pressure, claustrophobia, air leaks, feelings of suffocation, and inability to change sleep routine.…”

Reduced Apnea-Hypopnea Index in Patients with Severe Sleep Apnea Syndrome as Determined by Cervical Collar and Mandibular Advancement Device Combination Therapy

“…Maintaining this compliance requires intensive education, motivational enhancement and support [19,20]. Patients with severe OSAS need to use CPAP to prevent the risks associated with the disease.…”