CPAP is the cornerstone treatment for OSAS, yet its compliance was unsatisfactory. Attempt is made to look at the factors associated with compliance.
A retrospective study evaluating CPAP compliance in a group of newly diagnosed OSAS Chinese patients in a regional hospital over a 6-month period (August 2003 - February 2004). Objective and self-reported compliance was obtained 6 months after commencing CPAP. Acceptable compliance was defined as CPAP usage for at least 4 hours/day in at least 70% of the night. Suboptimal treatment was defined as either refusal of CPAP treatment or unsatisfactory CPAP compliance. Newly diagnosed patients are invited to attend a specialty-nurse conducted educational session on OSAS before physician assessment.
One hundred and six subjects were diagnosed to have OSAS. Only 58 patients (54.7%) accepted CPAP treatment. Fifty patients (86.2%) fulfilled the criteria of acceptable compliance (mean5.9±1.3 hours/day) and 8 had unsatisfactory compliance (mean 3.0±1.7 hours/day). Attendance of the education class (p=0.007) and number of side effects experienced by patients (p=0.007) were independent predictors of satisfactory compliance. Fifty-six (52.8%) either declined or failed to comply to CPAP satisfactorily. There were no significant differences in age, sex distribution, presenting symptoms, degree of sleepiness, level of CPAP pressure, and type of side effects experienced between the 2 groups. Univariate analysis suggested associations of optimal treatment with greater body weight (p<0.05) and body mass index (p< 0.01), higher respiratory disturbance index (p< 0.05), higher desaturation index (p<0.01), higher arousal index (p< 0.05), having hypertension (p< 0.01), attendance of an education session (p< 0.001). Using logistic regression, CPAP education was the only independent predictor of both good acceptance and compliance (p< 0.001).
CPAP acceptance rate was fair (54.7%). A single educational session could improve CPAP acceptance and compliance in newly diagnosed OSAS patients.
Since augmented CPAP education has not been shown to offer additional benefits (Hui DSC et al. Chest 2000), basic education appears a cost-effective intervention in improving acceptance and compliance rate.
Maggie Lit, None.