Long-term compliance with continuous positive airway pressure in Saudi patients with obstructive sleep apnea. A prospective cohort study

Abstract Background Although continuous positive airway pressure (CPAP) is the first line treatment for obstructive sleep apnea (OSA) patients, the perioperative adherence rate is unclear. The objective of this study was to determine the perioperative adherence rate of patients with OSA with a CPAP prescription and the effect of adherence on nocturnal oxygen saturation. Methods This prospective cohort study included adult surgical patients with a diagnosis of OSA with CPAP prescription undergoing elective non-cardiac surgery. Patients were divided into CPAP adherent and non-adherent groups based on duration of usage (≥ 4 h/night). Overnight oximetry was performed preoperatively and on postoperative night 1 and 2 (N1, N2). The primary outcome was adherence rate and the secondary outcome was nocturnal oxygen saturation. Results One hundred and thirty-two patients completed the study. CPAP adherence was 61% preoperatively, 58% on postoperative N1, and 59% on N2. Forty-nine percent were consistently CPAP adherent pre- and postoperatively. Using a linear fixed effects regression, oxygen desaturation index (ODI) was significantly improved by CPAP adherence (p = 0.0011). The interaction term CPAP x N1 was significant (p = 0.0015), suggesting that the effect of CPAP adherence varied on N1 vs preoperatively. There was no benefit of CPAP adherence on postoperative mean SpO2, minimum SpO2, and percentage of sleep duration with SpO2 < 90%. Use of supplemental oxygen therapy was much lower in the CPAP adherent group vs non-adherent group (9.8% vs 46.5%, p < 0.001). Conclusions Among patients with a preoperative CPAP prescription, approximately 50% were consistently adherent. CPAP adherence was associated with improved preoperative ODI and the benefit was maintained on N1. These modest effects may be underestimated by a higher severity of OSA in the CPAP adherent group and a higher rate of oxygen supplementation in the non-adherent group. Trial registration ClinicalTrials.Gov registry (NCT02796846).

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1017 CLINICAL OUTCOMES OF CONTINUOUS POSITIVE AIRWAY PRESSURE IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA AND NON-DIPPING BLOOD PRESSURE: A PROSPECTIVE COHORT STUDY

SLEEP ◽

10.1093/sleepj/zsx050.1016 ◽

2017 ◽

Vol 40 (suppl_1) ◽

pp. A379-A379

Author(s):

H Huang ◽

C Lee ◽

S Lin ◽

L Chuang ◽

C Chang ◽

...

Keyword(s):

Blood Pressure ◽

Obstructive Sleep Apnea ◽

Cohort Study ◽

Sleep Apnea ◽

Continuous Positive Airway Pressure ◽

Clinical Outcomes ◽

Prospective Cohort ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Obstructive Sleep

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Perioperative Adherence to Continuous Positive Airway Pressure and its Effect on Postoperative Nocturnal Hypoxemia in Obstructive Sleep Apnea Patients: a Prospective Cohort Study

10.21203/rs.3.rs-117924/v1 ◽

2020 ◽

Author(s):

Colin Suen ◽

Jean Wong ◽

Kahiye Warsame ◽

Yamini Subramani ◽

Tony Panzarella ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Cohort Study ◽

Sleep Apnea ◽

Continuous Positive Airway Pressure ◽

Prospective Cohort ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Adherence Rate ◽

Cpap Adherence ◽

Obstructive Sleep

Abstract BackgroundAlthough continuous positive airway pressure (CPAP) is the first line treatment for obstructive sleep apnea (OSA) patients, the perioperative adherence rate is unclear. The objective of this study was to determine the perioperative adherence rate of patients with OSA with a CPAP prescription and the effect of adherence on nocturnal oxygen saturation.MethodsThis prospective cohort study included adult surgical patients with a diagnosis of OSA with CPAP prescription undergoing elective non-cardiac surgery. Patients were divided into CPAP adherent and non-adherent groups based on duration of usage (≥ 4h/night). Overnight oximetry was performed preoperatively and on postoperative night 1 and 2 (N1, N2). The primary outcome was adherence rate and secondary outcomes were nocturnal oxygen saturation.ResultsOne hundred and thirty-two patients completed the study. CPAP adherence was 61% preoperatively, 58% on postoperative N1, and 59% on N2. Forty-nine percent were consistently CPAP adherent pre- and postoperatively. Using a linear fixed effects regression, oxygen desaturation index (ODI) was significantly improved by CPAP adherence (p = 0.0011). The interaction term CPAP x N1 was significant (p = 0.0015), suggesting that the effect of CPAP adherence varied on N1 vs preoperatively. There was no benefit of CPAP adherence on postoperative mean SpO2, minimum SpO2, and percentage of sleep duration with SpO2 <90%. Supplemental oxygen therapy was higher in the CPAP non-adherent group vs adherent group on N1 (47% vs 9.8%, p < 0.001).ConclusionsAmong patients with a preoperative CPAP prescription, approximately 50% were consistently adherent. CPAP adherence was associated with improved preoperative ODI and the benefit was maintained on N1 and improved pain control. These modest effects may be underestimated by a higher severity of OSA in the CPAP adherent group and a higher rate of oxygen supplementation in the non-adherent group.Trial registrationClinicalTrials.Gov registry (NCT02796846).

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