PURPOSE: To determine if CPAP education and acclimatization session prior to titration study and CPAP therapy improves compliance.
METHODS: Retrospective study of patients who were referred to a hospital based sleep center for diagnosis of obstructive sleep apnea. Patients were included in the study if they had an AHI > 15 or AHI > 5 with cardiovascular risk factors. Patients were all started on heated humidification with ramp feature and seen in follow-up 1, 3 and 6 months post initiation of therapy. Patients were divided into an intervention group if they received CPAP education and mask acclimatization prior to having titration study and a control group who received traditional education post titration study. Compliance data was reported by patients with downloads from CPAP machines.
RESULTS: 88 patients were included in the study. They had a mean age of 48.9 years with 77.2% males. Of the 88 patients, 50 patients received CPAP education and acclimatization prior to their study. There was no statistical difference in the two groups with regards to age, AHI or the Epworth Sleepiness Scale (p > 0.05). There was a male predominance with lower body mass index in the control group (84% versus 67%; 33.8 versus 37.82). CPAP compliance was better in the intervention group both in terms of hours per night and nights per week used (5.8 versus 3.66 hours/night and 6.2 versus 3.92 nights/week; p < 0.001). 34 % of patients failed to use CPAP in the control group versus 8% in the intervention group.
CONCLUSION: Education and mask acclimatization prior to initiating titration study may be crucial in helping patients be more compliant and receptive to therapy.
CLINICAL IMPLICATIONS: Continuous positive airway pressure (CPAP) maintaining adequate airway patience is an accepted standard therapy for obstructive sleep apnea but the compliance is often poor despite various methods to improve compliance. Few studies address the impact of education and acclimatization prior to a titration study.
DISCLOSURE: Agnieszka Petersen, None.