PURPOSE: BACKGROUND: Continuous Positive Airways Pressure (CPAP) is considered to be the cornerstone of therapy for obstructive sleep apnea (OSA). However, compliance with this treatment is frequently poor, which may lead to ongoing symptoms of sleep disruption, daytime sleepiness and poor waking cognitive function. Previous studies have shown that cognitive interventions including patient education may improve compliance with CPAP.AIM: To determine the efficacy of showing patients with OSA their graphic polysomnography (PSG) data in increasing their CPAP compliance.
METHODS: METHODS: Participants included patients with OSA (n= 23, diagnosed on prior PSG), who were prospectively randomized into experimental arm or control arm. The experimental arm (n=12) was shown detailed PSG data including graphic data from PSG prior to prescription of CPAP. The control arm (n=11) was shown the paper report of the PSG. Compliance data, collected using CPAP devices with internal microprocessors, was read at 4 weeks after treatment initiation.
RESULTS: RESULTS: The mean age of our patient population was 54.9 years and 87% were male. Mean body mass index (BMI) was 30.9 kg/m2 and mean apnea hypopnea index (AHI) was 25.8/hour. There was no difference in age (52.5 vs 57.1 years, p=0.4), BMI (30.91 vs 30.96 kg/m2, p=0.8) and AHI (22.7 vs 28.6 / hour, p=0.5) between experimental and control arm. There was no difference in percent of days the CPAP was used (53.9% vs 69.1%, p=0.2) and average number of hours each night the CPAP was used (3.6 vs 4.4 hours) between experimental and control arm respectively. In multi logistic regression models which included age, BMI, AHI and experimental intervention, only BMI was found to increase likelihood of improved compliance (OR=39.0, p=0.009).
CONCLUSION: CONCLUSION: Showing patient graphic PSG data does not seem to improve compliance to CPAP. BMI is a very strong predictor of CPAP compliance.
CLINICAL IMPLICATIONS: Awareness of the factors effecting compliance can effect the impact of treatment on patient outcomes.
DISCLOSURE: Rashid Nadeem, No Financial Disclosure Information; No Product/Research Disclosure Information