Sleep Disorders |

Adherence to Continuous Positive Airway Pressure (CPAP) Therapy FREE TO VIEW

Eric Deflandre, MD; Stephanie Degey, MHS; Vincent Bonhomme, PhD; Anne-Francoise Donneau, MVSc; Robert Poirrier, PhD; Jean-Francois Brichant, PhD; Pol Hans, PhD
Author and Funding Information

Cabinet Medical ASTES & Clinique Saint-Luc, Namur, Belgium

Chest. 2014;145(3_MeetingAbstracts):585A. doi:10.1378/chest.1788934
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SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Obstructive Sleep Apnea (OSA) represents a perioperative risk. Continuous positive airway pressure (CPAP) therapy has demonstrated its ability to reduce this risk. However, many patients don’t adhere to this treatment. Our study was designed to identify patients with poor adherence to CPAP therapy.

METHODS: After IRP approval and informed consent, we include 90 consecutive patients who were treated by CPAP for over a year. According to a CPAP use of more or less than 4 hours per night, they were split into two groups: adherent or non-adherent. 62 potential causes of non-adherence were listed and presented to patients. The questions were divided into five categories: demographic and socioeconomic, CPAP-related problem, upper airway-related problem, physiopathology and beliefs about health. A multivariate logistic regression was used to identify significant causes of non-adherence to CPAP therapy. A two-tailed P value lower than 0.05 was considered significant.

RESULTS: 75 patients (83.3%) were considered to be adherent and 15 (16.7%) as non-adherent. Three criteria were significant for adherence to CPAP (OR ; CI 95%) : 1) being aware of the risk of complications if not using CPAP (2.54 ; 1.36-4.75) ; 2) being aware that CPAP treatment is effective (3.19 ; 1.2-8.46) ; 3) feeling of being less sleepy during the day after starting CPAP therapy (1.74 ; 1.2-2.52). One criteria was significant for non-adherence to CPAP: feeling of breathlessness with the CPAP mask (0.42 ; 0.25-0.72)

CONCLUSIONS: Our study corroborates already published data but highlights previously unidentified factors of compliance. Although our two groups are not fully matched, our results clearly isolate 4 criteria that every anesthesiologist should seek during the preoperative visit. Our results must be confirmed by a study on a larger scale.

CLINICAL IMPLICATIONS: Our study would allow detecting more efficiently non-adherent patient to CPAP therapy. Isolating insufficiently treated OSA patients with increased postoperative risk would allow better orienting toward in- or outpatient surgery management.

DISCLOSURE: The following authors have nothing to disclose: Eric Deflandre, Stephanie Degey, Vincent Bonhomme, Anne-Francoise Donneau, Robert Poirrier, Jean-Francois Brichant, Pol Hans

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