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Clinical Investigations: SLEEP AND BREATHING |

Long-term Compliance Rates to Continuous Positive Airway Pressure in Obstructive Sleep Apnea*: A Population-Based Study

Don D. Sin, MD; Irvin Mayers, MD, FCCP; Godfrey C. W. Man, MBBS, FCCP; Larry Pawluk, MD
Author and Funding Information

*From the Departments of Pulmonary Medicine (Drs. Sin, Mayers, and Man) and Psychiatry (Dr. Pawluk), University of Alberta, Edmonton, AB, Canada.

Correspondence to: Don D. Sin, MD, 2E4.29 Walter C. Mackenzie Center, University of Alberta, Edmonton, AB, Canada, T6G 2B7; e-mail: don.sin@ualberta.ca



Chest. 2002;121(2):430-435. doi:10.1378/chest.121.2.430
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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 longitudinal study.

Setting: University sleep disorders center.

Patients: Two hundred ninety-six patients with an apnea-hypopnea index (AHI) ≥ 20/h on polysomnography.

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.

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