Influence of a structured follow-up on CPAP adherence in patients with an OSAS

Abstract

Continuous positive airway pressure (CPAP) therapy is the reference therapy for moderate and severe obstructive sleep apnea syndrome (OSAS). However, CPAP adherence is dissatisfying. We analyzed influencing factors on CPAP adherence and we evaluated if a structured follow-up enhances its adherence. In this study all patients (n = 237) with a newly adjusted CPAP therapy due to the diagnosis of mild to severe OSAS between 2011 and 2013 were investigated. Follow-up took place every 1593.7 ± 77.4 CPAP operation hours. AHI (Apnea-hypopnea index) decreased significantly during therapy (5.6 ± 8.5/h; p < 0.001). 79 % fulfilled the criteria of CPAP adherence (at least 4 operation hours at 7 days a week). There were no significant influences on CPAP adherence seen in patients' demographic, clinical and pharmacological characteristics. The most common problems of patients receiving a CPAP therapy were dryness of the mucous membranes (43.7 %) and pressure marks (22.4 %). Considering the changes in Epworth Sleepiness Scale there were no significant relations to CPAP adherence. Satisfaction with our follow-up significantly correlated with CPAP adherence (r = 0.185; p = 0.032), whereas therapy pressure did not have any significant influence on CPAP adherence (r = -0.072; p = 0.383). A structured and individually adapted follow-up is important. In future, apart from control of therapy success, greater attention in the follow-up of CPAP therapy should be given to aspects of problem solution, feedback, education, and motivation.