Objectives: To study the effects of augmentation of
continuous positive airway pressure (CPAP) education and support on
compliance and outcome in patients with obstructive sleep apnea
Design: A randomized, controlled, parallel
study of basic vs augmented CPAP education and support.
Setting: A university teaching hospital.
Patients: A total of 108 OSA patients randomized into
basic-support (BS) and augmented-support (AS) groups.
Interventions: Patients in the BS group (n = 54) were
given educational brochures on OSA and CPAP, CPAP education by nurses,
CPAP acclimatization, and were reviewed by physicians and nurses at
weeks 4 and 12. Patients in the AS group (n = 54) received more
education, including a videotape, telephone support by nurses, and
early review at weeks 1 and 2.
CPAP compliance, Calgary sleep apnea quality of life index (SAQLI), and
cognitive function after 1 month and 3 months; and Epworth sleepiness
scale (ESS) after 3 months of CPAP treatment.
At 4 weeks, CPAP usage was 5.3 ± 0.2 h/night (mean ± SEM) vs
5.5 ± 0.2 h/night in the BS and AS groups, respectively (p = 0.4).
At 12 weeks, CPAP usage was 5.3 ± 0.3 h/night vs 5.3 ± 0.2
h/night in the two groups, respectively (p = 0.98). There was greater
improvement of SAQLI at 4 weeks (p = 0.008) and at 12 weeks
(p = 0.047) in the AS group. There was no significant difference
between BS and AS groups in terms of improvement of ESS and cognitive
Conclusion: Augmentation of CPAP education
and support does not increase CPAP compliance, but leads to a greater
improvement of quality of life during the reinforced