Study objectives: To determine long-term compliance
rates to continuous positive airway pressure (CPAP) therapy in patients
with obstructive sleep apnea enrolled in a comprehensive CPAP program
in the community.
Design: Prospective cohort
Setting: University sleep
Patients: Two hundred ninety-six
patients with an apnea-hypopnea index (AHI) ≥ 20/h on
Interventions: A CPAP device equipped
with a monitoring chip was supplied. Within the first week, daily
telephone contacts were made. Patients were seen at 2 weeks, 4 weeks, 3
months, and 6 months.
Results: Of the 296 subjects
enrolled, 81.1% were males. Mean ± SD AHI was 64.4 ± 34.2/h of
sleep; age, 51 ± 11.7 years; and body mass index, 35.2 ± 7.9
kg/m2. The mean duration of CPAP use was 5.7 h/d at 2
weeks, 5.7 h/d at 4 weeks, 5.9 h/d at 3 months, and 5.8 h/d at 6
months. The percentage of patients using CPAP ≥ 3.5 h/d was 89.0% at
2 weeks, 86.6% at 4 weeks, 88.6% at 3 months, and 88.5% at 6 months.
There was a decrease in the Epworth Sleepiness Scale (ESS) score of
44% by 2 weeks of therapy. The patients continue to improve over the
follow-up period, with the lowest mean ESS score observed at 6 months.
With multiple regression analysis, three variables were found to be
significantly correlated with increased CPAP use: female gender,
increasing age, and reduction in ESS score.
Conclusion: A population-based CPAP program consisting of
consistent follow-up, “troubleshooting,” and regular feedback to
both patients and physicians can achieve CPAP compliance rates of>
85% over 6 months.