Flexible positive airway pressure improves treatment adherence compared with auto-adjusting PAP.

Abstract

STUDY OBJECTIVES:

There are no clinical data comparing adherence and quality of life between auto-adjusting positive airway pressure (APAP) and two different flex positive airway pressure (PAP) devices (A-Flex, C-Flex) in patients with obstructive sleep apnea (OSA).

DESIGN AND SETTING:

Ninety-three patients in whom OSA was newly diagnosed were randomly assigned to receive 3 mo of APAP (n = 31), APAP with C-Flex (n = 31), or APAP with A-Flex (n = 31). Objective adherence was determined after 3 mo of CPAP treatment, and the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Calgary Sleep Apnea Quality of Life Index (SAQLI) were examined at baseline and after 3 mo. After 3 mo, patients in the APAP with A-Flex group and those in the APAP with C-Flex group were crossed over and those in the APAP group were switched to A-Flex for an additional 3 mo.

MEASUREMENTS AND RESULTS:

The groups were similar demographically. Treatment adherence during the first 3 mo was significantly greater in the APAP with C-Flex group (APAP with C-Flex: 5.19 ± 1.84 h/night versus APAP: 3.96 ± 1.66 h/night versus APAP with A-Flex: 4.27 ± 2.12 h/night, P = 0.04). There was a significant improvement in two of four of the SAQLI domain scores and in the ESS and PSQI in the APAP with C-Flex group. Adherence significantly improved among the poor compliers (< 4 h/night of use) in the APAP group after change to APAP with A-Flex (P = 0.01).

CONCLUSIONS:

Of these three modes of PAP delivery, adherence was greatest with APAP with C-Flex.

CLINICAL TRIAL REGISTRATION:

URL: http://www.clinicaltrials.gov. Unique identifier: NCT00873977.

• Authors: Yuichi Chihara, Tomomasa Tsuboi, Takefumi Hitomi, Masanori Azuma, Kimihiko Murase, Yoshiro Toyama, Yuka Harada, Kensaku Aihara, Kiminobu Tanizawa, Tomohiro Handa, Chikara Yoshimura, Toru Oga, Kazuhiko Yamamoto, Michiaki Mishima, Kazuo Chin
• Journal: Sleep (Sleep) Vol. 36 Issue 2 Pg. 229-36 (Feb 01 2013) ISSN: 1550-9109 [Electronic] United States
• PMID: 23372270 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Continuous Positive Airway Pressure (instrumentation, methods, psychology)
• Cross-Over Studies
• Female
• Humans
• Male
• Middle Aged
• Patient Compliance
• Polysomnography
• Single-Blind Method
• Sleep Apnea, Obstructive (psychology, therapy)