Poor compliance and low satisfaction with continuous positive airway pressure (CPAP) are significant obstacles in the treatment of obstructive sleep apnea(OSA). We investigated the polysomnographic (PSG) and clinical predictors of compliance and satisfaction in patients treated with CPAP after a “diagnostic/titration split-night protocol” (SNP).
We studied 122 consecutive patients 3-6 months after SNP. Satisfaction, compliance, and side effects of the CPAP were assessed using a questionnaire. Compliance was validated by examination of meter reading. PSG variables during the SNP were analyzed.
During SNP increased slow-wave sleep (SWS) during the titration was correlated with compliance (p=0.037). The obstructive apnea index (OAI) during the diagnostic part of the SNP was correlated with compliance (p = 0.021) and satisfaction (p= 0.011).Clinical correlates of long term compliance included increasing age, improvement in subjective daytime concentration, quality of life, vitality and mood (all p<0.01). Improvement in sleep quality and reduction of the Epworth score after CPAP were strong predictors for long term compliance and satisfaction with CPAP (p = 0.0001).Taking the CPAP mask off during sleep was negatively correlated with compliance (p=0.0003). Pain related to the CPAP was negatively correlated with satisfaction (p = 0.021).
High OAI during the diagnostic part of the SNP and increase of SWS during the titration part of the SNP can predict long term compliance and satisfaction with CPAP. However, clinical parameters including reduction in the Epworth score and improvement in the sleep quality are even better predictors of long term compliance and satisfaction with CPAP.
SNP sleep architecture and especially clinical parameters are of predictive value in estimation of long term compliance and satisfaction with CPAP.
Osama Elkhouli, None.