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Sleep Disorders |

Does Severity of OSA Predict CPAP Compliance?

Agustina Saenz*, MD; Carlos Davila, MD; Ganesan Murali, MD
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Albert Einstein Medical Center, Philadelphia, PA


Chest. 2012;142(4_MeetingAbstracts):1066A. doi:10.1378/chest.1390459
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Abstract

SESSION TYPE: Sleep Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: CPAP has been proved to be a good treatment for Obstructive sleep apnea (OSA) but the compliance has been reported to be suboptimal. Most of the studies in the literature showed that severity of OSA, mainly measured by the Apnea-Hypopnea Index (AHI) and the Epworth Sleepiness score (ESS) was associated with better CPAP adherence.

METHODS: We reviewed the charts of 110 patients being followed at the sleep clinic at Albert Einstein Medical Center, Philadelphia, of whom we had compliance reports. Compliance was defined as use of CPAP for at least 4 hour/ night for more than 70% of the time during a 2 month period. The following variables were evaluated: gender, BMI, insurance coverage, AHI (Total and during REM), ESS and T90 (Time with oxygen saturation below 90%).

RESULTS: Overall compliance was 36%. Adherence was 69% on patients with a T90>50. (vs 32% T90< 50, p-value 0.0059) The compliance was below 50% without significant difference between severities of these parameters: gender, BMI, AHI or insurance status. In our population, better compliance was observed in patients with lower Epworth score (50% vs. 30%, p-value 0.0338).

CONCLUSIONS: CPAP compliance is very poor in our inner city population. Only T90 >50% was statistically significant to predict adherence. Neither the BMI, AHI, lack of insurance were good predictors of use of CPAP. Paradoxically, a lower score in the Epworth sleepiness scale was associated with better compliance. Higher BMI did not necessarily correspond with worse AHI.

CLINICAL IMPLICATIONS: More studies in urban population are necessary to better predict use of CPAP and to evaluate the effects of patient education on CPAP compliance.

DISCLOSURE: The following authors have nothing to disclose: Agustina Saenz, Carlos Davila, Ganesan Murali

No Product/Research Disclosure Information

Albert Einstein Medical Center, Philadelphia, PA

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