Long-term compliance to continuous positive airway pressure therapy in patients with severe sleep apnea syndrome

Year 2020, Volume: 12 Issue: 2, 194 - 199, 01.06.2020

Meltem Tulğar Murad Mutlu Melike Yüceege Hikmet Fırat Sadık Ardıç

https://doi.org/10.21601/ortadogutipdergisi.715620

Abstract

Background and Aim: Compliance is the adherence of the patient to continuous positive airway pressure (CPAP) therapy after his/her decision to start treatment. The aim of this study is to evaluate the compliance to CPAP therapy in a large patient population and the results were presented after 5 years of follow-up period in order to emphasize long-term compliance with CPAP treatment in the light of the literature.

Materials and Methods: Patients who could not afford CPAP device or attend regular controls were excluded from the study and the remaining 174 patients were included in the study. At the end of 5 years, the patients were called back. A total of 110 patients met the eligibility criteria for the study110 patients (79 males, 31 females) whose charts were reviewed.

Results: Fifty of 110 study participants (45.5%) regularly used CPAP device for ≥4 hours and the remaining 60 (54.5%) patients did not use CPAP device regularly. At the end of 5 years, we found that 36.4% of the patients used the device 4 hours a night. AHI severity does not affect adherence to the device and compliance rates (2=2.743; p=0.254).

Conclusion: The patients compliance rates with CPAP device was found concord with the literature. This study conveys greater importance than other relevant studies in the literature in that it encompasses a larger patient population followed up for a longer period.

Keywords

sleep apnea syndrome, positive airway pressure, compliance

Şiddetli uyku apne sendromu olan hastalarda sürekli pozitif hava yolu basıncı tedavisine uzun süreli uyum

Abstract

Giriş ve Amaç: Kompliyans, hastanın tedaviye başlama kararından sonra sürekli pozitif havayolu basıncı (CPAP) tedavisine uymasıdır. Bu çalışmanın amacı, geniş bir hasta popülasyonunda CPAP tedavisine uyumu değerlendirmektir ve sonuçlar literatür ışığında CPAP tedavisine uzun vadeli uyumu vurgulamak amacıyla 5 yıllık takip süresinden sonra sunulmuştur.

Gereç ve Yöntem: CPAP cihazı alamayan veya düzenli kontrollere katılamayan hastalar çalışmaya alınmadı ve kalan 174 hasta çalışmaya dahil edildi. 5 yılın sonunda hastalar geri çağrıldı. Toplam 110 hasta, çizelgeleri gözden geçirilmiş 110 hasta (79 erkek, 31 kadın) için uygunluk kriterlerini karşılamıştır.

Bulgular: Çalışmaya katılan 110 kişiden 50'si (%45,5) düzenli olarak ≥4 saat CPAP cihazı kullanmış ve geri kalan 60 (%54,5) hasta düzenli olarak CPAP cihazı kullanmamıştır. 5 yılın sonunda hastaların %36,4'ünün cihazı gece 4 saat kullandığını tespit ettik. AHI şiddeti cihaza uyumu ve uyum oranlarını etkilemez (2 = 2,743; p = 0,254).

Sonuç: Hastaların CPAP cihazına uyum oranları literatürle uyumlu bulunmuştur. Bu çalışma, daha uzun süre takip edilen daha geniş bir hasta popülasyonunu kapsaması bakımından literatürdeki diğer ilgili çalışmalardan daha fazla önem taşımaktadır.

Keywords

uyku apne sendromu, pozitif hava yolu basıncı, kompliyans

References

• ASDA-Diagnostic Classification Steering Committee. In: Lawrencve, KS ed. The International Classification of Sleep Disorders. Diagnoztic and Coding Manual 2nd ed. Allen Press Inc; 1997.
• Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Javier Nieto F, O’Connor GT, Boland LL, Schwartz JE, Samet JM. Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 2001; 163(1): 19-25.
• Berry RB, Sanders MH. Positive airway pressure treatment for sleep apnea. In: Carney PR, Berry RB, Geyer JD (Eds). Clinical sleep disorders. Philadelphia: 0*Lippincott Williams and Wilkins; 2005: 290-310.
• Dobrowski JM, Ahmed M. Positive airway pressure for obstructive sleep apnea. In: Fairbanks DNF, Mickelson SA, Woodson BT (Eds), Snoring and obstructive sleep apnea, 3rd Ed. Philadelphia: Lippincott Williams and Wilkins; 2003: 95-106.
• Kuna ST, Bedi DG, Ryckman C. Effect of nasal airway positive pressure on upper airway size and configuration. Am Rev Respir Dis 1988; 138: 969-75.
• Engleman HM, Wild MR. Improving CPAP use by patients with the sleep apnea/hypopnea syndrome. Sleep Med Rev 2003; 7: 81-99.
• Engleman HM, Marlin SE, Douglas NJ. Compliance with CPAP therapy in patients with the sleep apnea / hypopnea syndrome. Thorax 1994; 49: 263-6.
• Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc 2008; 5(2): 173-8.
• Hoffstein V, Viner S, Mateika S and Conway J. Treatment of obstructive sleep apnea with nasal continuous positive airway pres- sure. Am Rev Respir Dis 1992; 145: 841-5.
• Krieger J, Kurtz D, Petiau C, Sforza E, Trautmann D. Long-term compliance with CPAP therapy in obstructive sleep apnea patients and in snorers. Sleep 1996; 19(9 Suppl): S136-143.
• McArdle N, Devereux G, Heidarnejad H, Engleman HM, Mackay TW, Douglas NJ. Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 1999; 159(4 Pt 1): 1108-14.
• Grunstein R. Continuous positive airway pressure treatment for obstructive sleep apnea-hypopnea syndrome. In: Kryger MH, Roth T, Dement WC (Eds.). Principles and practice of sleep medicine. Philadelphia: Elsevier Saunders, 2005: 1066-80.
• Hui DS, Chan JK, Choy DK, Ko FW, Li TS, Leung RC, Lai CK. Effects of augmented continuous positive airway pressure education and support on compliance and outcome in a Chinese population. Chest 2000; 117(5): 1410-6.
• Sanders MH, Strollo PJ, Stiller RA. Positive airway pressure in the treatment of sleep-related breathing disorders. In: Chokroverty S (ed), Sleep disorders medicine. Boston: Butter-Worth- Heinemann; 1999: 355-84.
• Strollo PJ, Sanders MH, Atwood CW. Positive pressure therapy. Clin Chest Med 1998; 19: 55-68.
• Sanders MH, Gruendl CA, Rogers RM. Patient compliance with nasal CPAP therapy for sleep apnea. Chest 1986; 90(3): 330-3.
• Kribbs NB, Pack AI, Kline LR, Smith PL, Schwartz AR, Schubert NM, Redline S, Henry JN, Getsy JE, Dinges DF. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis 1993; 147(4): 887-95.
• Rauscher H, Popp W, Wanke T, Zwick H. Acceptance of CPAP therapy for sleep apnea. Chest 1991; 100(4): 1019-23.
• Hussain, S.F. Irfan, M., Waheed, Z. et al. Compliance with continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea among privately paying patients- a cross sectional study. BMC Pulm Med 2014; 14:188.
• Lee CHK, Leow LC, Song PR, Li H, Ong TH. Acceptance and adherence to continuous positive airway pressure therapy in patients with obstructive sleep apnea (OSA) in a southeast Asian privately funded healthcare system. Sleep Science, 2017; 10(2): 57-63.