Long term effects of compliance with positive airway pressure (PAP) therapy in patients with obesity hypoventilation syndrome (OHS)

Abstract

Background: There is limited data concerning long-term effects of positive airway pressure (PAP) therapy on survival and functional status in patients with obesity hypoventilation syndrome (OHS). Aims: To assess the role of different levels of compliance and long-term effects of PAP therapy on gas exchange, sleepiness, quality of life, depression and death rate in patients with OHS. Methods: Two hundred fifty two OHS patients, newly diagnosed, who have been recommended PAP therapy, were followed up for a minimum of 2 years. Arterial blood samples were taken for gas level measurements with patients awake, for more than 4 h since wakening.The hours/day and percentage of days PAP was used were monitored. Epworth sleepiness scale (ESS), quality of life (Short Form 36-SF-36) and Beck Depression Inventory (BDI) were recorded together with the death rate before and at the end of the follow up period. Results: At the end of thefollow-up period (mean duration, 50 months), PaO 2 had increased from baseline (p 2 and HCO 3 − had decreased (p 6 hours/day had a considerably greater improvement in blood gases and questionnaires scores than less adherent patients. Conclusions: Increased hours of use and long-term therapy with PAP are effective in the treatment of patients with OHS. Clinicians should encourage adherence to PAP therapy in order to provide a significant improvement in clinical status and gas exchange in these patients.