Polysomnograph Chart View by Patients: A New Educational Strategy to Improve CPAP Adherence in Sleep Apnea Therapy

Patients with sleep apnea are usually treated with continuous positive airway pressure (CPAP). This therapy is very effective if the patient′s adherence is satisfactory. However, although CPAP adherence is usually acceptable during the first months of therapy, it progressively decreases, with a considerable number of patients accepting average treatment duration below the effectiveness threshold (4 h/night). Herein, our aim was to describe and evaluate a novel telemedicine strategy for rescuing CPAP treatment in patients with low adherence after several months/years of treatment. This two-week intervention includes (1) patient support using a smartphone application, phone and voice recorder messages to be answered by a nurse, and (2) daily transmission and analysis of signals from the CPAP device and potential variation of nasal pressure if required. On average, at the end of the intervention, median CPAP adherence considerably increased by 2.17 h/night (from 3.07 to 5.24 h/night). Interestingly, the procedure was able to markedly rescue CPAP adherence: the number of patients with poor adherence (<4 h/night) was considerably reduced from 38 to 7. After one month, adherence improvement was maintained (median 5.09 h/night), and only 13 patients had poor adherence (<4 h/night). This telemedicine intervention (103€ per included patient) is a cost-effective tool for substantially increasing the number of patients with CPAP adherence above the minimum threshold for achieving positive therapeutic effects.

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Is Prediction of CPAP Adherence in Obstructive Sleep Apnea in the Perioperative Setting Feasible?

Journal of Clinical Sleep Medicine ◽

10.5664/jcsm.2856 ◽

2013 ◽

Vol 09 (07) ◽

pp. 731-731

Author(s):

Antonio M. Esquinas ◽

Peter Cistulli

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cpap Adherence ◽

Obstructive Sleep

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The effect of non-benzodiazepine sedative hypnotics on CPAP adherence in patients with OSA: a systematic review and meta-analysis

SLEEP ◽

10.1093/sleep/zsab077 ◽

2021 ◽

Author(s):

Donghao Wang ◽

Yongkang Tang ◽

Yanghang Chen ◽

Sun Zhang ◽

Danjie Ma ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Cpap Adherence ◽

Randomized Controlled ◽

Obstructive Sleep ◽

Sedative Hypnotics

Abstract Study objectives This meta-analysis aimed to explore the effect of non-benzodiazepine sedative hypnotics (NBSH) on continuous positive airway pressure (CPAP) adherence in patients with obstructive sleep apnea (OSA). Methods We conducted a systematic search through PubMed, Medline, the Cochrane Library, EMBASE, Scopus and ClinicalTrials (all searched from inception to 15 August 2020). Publications were limited to articles, clinical conferences and letters, including randomized controlled trials and retrospective studies. We used a random-effects model to calculate the odds ratio (OR) and mean difference (MD) with corresponding confidence interval (CI). Subgroup analyses were conducted to analyze the sources of heterogeneity. Results Eight studies fulfilled the inclusion and exclusion criteria for patients newly diagnosed with obstructive sleep apnea. Overall, the use of NBSH was associated with increased use of CPAP per night (MD = 0.62 h; 95% CI = 0.26-0.98) and use for more nights (MD = 12.08%; 95% CI = 5.27-18.88). When a study seriously affecting heterogeneity was removed, more patients adhered well with CPAP use (pooled OR = 2.48; 95% CI = 1.75-3.52) with good adherence defined as CPAP use for＞4 h/night on＞70% of nights. Among prescribed NBSHs, eszopiclone showed the most significant effect on CPAP adherence. Conclusion CPAP adherence may increase in OSA patients treated with non-benzodiazepine sedative hypnotics especially eszopiclone. The effect of zolpidem and zaleplon on CPAP adherence requires further investigation by larger scale, randomized, controlled trials.

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CPAP adherence reduces cardiovascular risk among older adults with obstructive sleep apnea

Sleep And Breathing ◽

10.1007/s11325-020-02239-2 ◽

2020 ◽

Author(s):

Emerson M. Wickwire ◽

M. Doyinsola Bailey ◽

Virend K. Somers ◽

Mukta C. Srivastava ◽

Steven M. Scharf ◽

...

Keyword(s):

Older Adults ◽

Obstructive Sleep Apnea ◽

Cardiovascular Risk ◽

Sleep Apnea ◽

Cpap Adherence ◽

Obstructive Sleep

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0632 The Correlation Between Severity of Obstructive Sleep Apnea and Patient Compliance

SLEEP ◽

10.1093/sleep/zsaa056.628 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A241-A241

Author(s):

A C Roberts ◽

G Bastin

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Patient Compliance ◽

Compliance Rate ◽

Newly Diagnosed ◽

Cpap Therapy ◽

Cpap Adherence ◽

Obstructive Sleep ◽

Significant Difference ◽

Cpap Compliance

Abstract Introduction Obstructive sleep apnea (OSA) is a prevalent disorder affecting 9-38% of the global population and is linked to multiple health complications. Continuous Positive Airway Pressure (CPAP) is regarded as the gold standard treatment for OSA, but its efficacy is limited by poor patient compliance. Studies have linked many clinical and lifestyle factors to CPAP adherence, but have produced conflicting outcomes. Based on the current literature, it is assumed patients diagnosed with severe OSA are more likely to be compliant with CPAP due to a greater improvement in quality of life. The goal of this study is to compare the compliance rate of CPAP for patients with mild, moderate, and severe OSA, as well as identify other potential predictors of CPAP compliance. Methods This study is a retrospective chart review of 100 patients who were newly diagnosed with OSA and started on CPAP between January 1, 2017 and January 1, 2018. Baseline demographic data, past medical history, OSA severity, Epworth sleepiness scale, and compliance to CPAP therapy were recorded. Compliance was defined as CPAP usage greater than four hours per night for at least 21 days per month. Results Mean follow-up time after CPAP initiation was 3.19 months. Overall 77% of patients were compliant to CPAP therapy, of which 48% were males and 52% were females (P=0.48). CPAP compliance rates for mild OSA (79.3%), moderate OSA (73.7%), and severe OSA (78.8%) showed no significant difference for independence (P=0.83) or correlation with compliance (P=0.99). Only seasonal allergic rhinitis showed a positive association with CPAP adherence (P=0.031) and depression showed a negative association (P=0.027). Conclusion The level of OSA severity is not a significant predictor of short-term CPAP compliance among newly diagnosed patients. Support Parkview Physicians Group, Indiana School of Medicine - Fort Wayne, and the Dr. Luis and Anne B Schneider Foundation.

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CPAP Adherence And Compliance In Elderly Patients With Obstructive Sleep Apnea

10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a6326 ◽

2011 ◽

Author(s):

Gimbada B. Mwenge ◽

Catherine Cuylen ◽

Pierre Delguste ◽

Gregory Reychler ◽

Daniel Rodenstein

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Elderly Patients ◽

Cpap Adherence ◽

Obstructive Sleep

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Validation of the CPAP Habit Index-5: A Tool to Understand Adherence to CPAP Treatment in Patients with Obstructive Sleep Apnea

Sleep Disorders ◽

10.1155/2014/929057 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Anders Broström ◽

Per Nilsen ◽

Benjamin Gardner ◽

Peter Johansson ◽

Martin Ulander ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Longitudinal Design ◽

Self Report ◽

Measurement Properties ◽

Cpap Adherence ◽

Cpap Treatment ◽

Obstructive Sleep ◽

Prospective Longitudinal

Long-term adherence to continuous positive airway pressure (CPAP) is low among patients with obstructive sleep apnea (OSA). The potential role of “habit” in sustaining adherence to CPAP use has not been studied. This study aimed to establish the relevance of habit to CPAP adherence, via validation of an adaptation of the Self-Report Habit Index (the CPAP Habit Index-5; CHI-5). Analyses focused on the homogeneity, reliability, and factor structure of the CHI-5 and, in line with theoretical predictions, its utility as a predictor of long-term CPAP adherence in middle-aged patients with OSA. A prospective longitudinal design was used. 117 patients with objectively verified OSA intended for CPAP treatment were recruited. Data was collected via clinical examinations, respiratory recordings, questionnaires, and CPAP devices at baseline, 2 weeks, 6 months, and 12 months. The CHI-5 showed satisfactory homogeneity interitem correlations (0.42–0.93), item-total correlations (0.58–0.91), and reliability (α= 0.92). CHI-5 data at 6 months showed a one-factor solution and predicted 63% of variance in total CPAP use hours after 12 months. Based on the satisfactory measurement properties and the high amount of CPAP use variance it explained, the CHI-5 can be seen as a useful tool in clinical practice.

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