Acceptance and long-term compliance of nCPAP in obstructive sleep apnea.

Abstract

In a retrospective cohort study, we evaluated whether improvements in nasal continuous positive airway pressure (nCPAP) technology, particularly the introduction of automatic adjustment of the nCPAP pressure (auto-CPAP), have led to better acceptance and (long-term) compliance in patients with obstructive sleep apnea syndrome (OSAS) as compared to earlier reported data. Questionnaires were sent to 256 patients, who were referred to our clinic for an overnight polysomnography from January 1997 to July 2005 and received nCPAP therapy for OSAS. Of the 256 patients, 24 patients were unavailable for follow-up. Of the remaining 232 patients, 58 patients (25%) had discontinued therapy, while 174 patients (75%) were still using nCPAP after 2 months to 8 years of follow-up. One Hundred and thirty eight (79%) of these 174 patients used nCPAP for at least 4 h/night during >or= 5 nights/week, 82,1% of the conventional nCPAP (fixed pressure CPAP) group (n = 78) and 77,1% of the auto-CPAP group (n = 96). Therefore, including the 58 failures, only 59.5% of patients can be seen as compliant. There were no statistical differences between the fixed pressure CPAP and auto-CPAP users, and between the compliant and non-compliant users according to age, BMI, AHI and Epworth sleepiness scale (ESS). Auto-CPAP patients used significantly more cm H2O. The long-term compliance of nCPAP therapy has have increased only slightly since the introduction of the fixed pressure CPAP 25 years ago, in spite of many efforts to improve it. It seems that a plateau has been reached and that it is unrealistic to aim at a substantially higher compliance rate.

• Authors: Wietske Richard, Jantine Venker, Cindy den Herder, Dennis Kox, Bob van den Berg, Martin Laman, Harm van Tinteren, Nico de Vries
• Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Eur Arch Otorhinolaryngol) Vol. 264 Issue 9 Pg. 1081-6 (Sep 2007) ISSN: 0937-4477 [Print] Germany
• PMID: 17443336 (Publication Type: Journal Article)

Topics

• Aged
• Attitude to Health
• Body Mass Index
• Continuous Positive Airway Pressure (methods)
• Female
• Humans
• Male
• Middle Aged
• Patient Compliance
• Patient Satisfaction
• Polysomnography (methods)
• Sleep Apnea, Obstructive (therapy)
• Surveys and Questionnaires
• Time Factors
• Treatment Outcome