Determinants of continuous positive airway pressure compliance in a group of Greek patients with obstructive sleep apnea

Abstract 

Objective

The aim of the study was to investigate the patients' characteristics that correlate with greater compliance to CPAP use.

Methods

Patients diagnosed with OSAHS and treated with CPAP, who had at least one follow-up visit in the Sleep Clinic during one year, were included in the study. Demographic data, history of symptoms, comorbidities, Body Mass Index (BMI), Epworth Sleepiness Scale questionnaire (ESS), were obtained from patients before and under CPAP use. All variables were correlated with average daily CPAP use. Objective and subjective compliance were estimated and a cut off point of 4.5h/d was used to distinguish ‘more compliant’ from less ‘compliant’ patients.

Results

Ninety eight patients, with a mean age (±SD) of 55.5 (±11.1) years were examined. Patients' symptoms improved after CPAP use. The objective compliance was 5.3±1.6h/d whereas the subjective compliance was higher. Only 25% of patients were characterized as ‘more compliant’. Compliance was positively correlated in a significant way with age and female gender, and negatively correlated with neck circumference, preexisting nasal problems and minimum saturation during sleep. Patients with arterial hypertension showed a trend to better compliance. Weight gain was more frequently observed in ‘less compliant’ patients.

Conclusion

To our knowledge this is the first study examining parameters of CPAP compliance in a Greek population of OSAHS patients. Age, gender and minimum saturation during sleep were related to better compliance whereas higher neck circumference and preexisting nasal problems were the parameters related to a worse adherence to treatment.

Keywords: Compliance, Continuous positive airway pressure (CPAP), Obstructive sleep apnea/hypopnea syndrome (OSAHS)