Comparison of CPAP adherence in two European sleep centres

Abstract

There is a lack of comparative data on long-term adherence to continuous positive airway pressure (CPAP) therapy in different countries. This study compared data on long-term subjective and objective adherence to CPAP therapy from two sleep research centres, one in Berlin, Germany, the other in Tampere, Finland. The objective was to compare adherence to CPAP therapy in order to identify predictors of good CPAP adherence. Retrospective data from obstructive sleep apnoea(OSA)-patients already undergoing CPAP therapy at sleep centres in Berlin and Tampere were collected. Data included subjective adherence (questionnaire), objective adherence (device data), patient demographics and clinical data. Potential selection bias of patients was carefully checked in both centres. After manual titration, there were significant differences in adherence between patients treated in Berlin (mean 6.14 ± 0.23 h/night) vs. Tampere (mean 4.24 ± 0.24 h/night; p < 0.001). Adherence to CPAP therapy was significantly better in patients with manual titration compared to automatic titration (p < 0.002). Patients tended to overestimate subjective adherence to CPAP. Hypertension has a significant influence on adherence. This study reports significant differences in long-term CPAP therapy adherence between two sleep research centres in different countries for the first time. The differences might result from different management of adverse effects, as well as from variation in the prevalence of comorbid hypertension, titration methods and other patient care procedures.