PURPOSE: Obstructive Sleep Apnea (OSA) affects 4% of the population. It has a negative impact on one’s quality of life, morbidity and mortality. While Continuous Positive Airway Pressure (CPAP) remains the safest and most effective nonsurgical therapy for OSA, the compliance rate is generally poor due to a variety of factors. This study was designed to assess three specific factors which might affect compliance: which group of patients had a higher compliance rate, those being treated by pulmonologists or those being treated by non-pulmonologists, and if the compliance rate is affected by age or Apnea-Hypopnea Index (AHI).
METHODS: A standard questionnaire was used to evaluate compliance rate in 40 patients with OSA who underwent overnight polysomnography and CPAP titration study. 21 patients (13 M, 8 F; mean age 50; mean AHI 57) who were referred and followed by pulmonologists, and 19 patients (12 M, 7 F; mean age 43; mean AHI 48) who were referred and followed by nonpulmonologists, were interviewed. None of the physicians were sleep medicine specialists. Patients were considered to be compliant with CPAP therapy if he or she used the CPAP device for ≥4 hours per night on 70% of nights for more than last 3 months.
RESULTS: Using the Fisher’s Exact Test, we found no significant difference in CPAP compliance rate between patients referred and followed by pulmonologists compared to patients referred and followed by nonpulmonologists (P-Value 0.20). Also the compliance rate was not affected by age (P-Value 0.10) or AHI (P-Value 0.48).
CONCLUSION: Positive Airway Pressure compliance rate in patients with Obstructive Sleep Apnea does not seem to be affected by the physician’s specialty (pulmonologist or non-pulmonoligist), patient’s age or Apena-Hypopnea Index. Further studies with larger numbers are warranted to evaluate these findings.
CLINICAL IMPLICATIONS: As this study failed to demonstrate a difference in compliance rates in patients being followed by pulmonologists and non-pulmonologists, perhaps the key to improving CPAP therapy compliance rate and maximization of its benefits is referral to a sleep specialist.
DISCLOSURE: Anwar Wassel, None.