Antimicrobial Compliance with CPAP in patients with obstructive sleep apnea: sleeping times with and without apparatus: A pilot study
Abstract
Background: It has long been understood that Continuous Positive Airway Presssure CPAP adherence is not perfect in most patients, which may impact the long-term therapeutic benefits of treatment. This study aimed to investigate the sleep patterns and compliance with treatment of adults with obstructive sleep apnoea who are using CPAP and how these may affect the disease-modifying effects of CPAP.
Methods: A cross-sectional analysis of CPAP compliance in patients with moderate-to-severe OSA. The data of patients visiting regional general practice were collected by a survey.
Results: More than half (66%) of the participants recorded partial compliance with CPAP, removing the apparatus and returning to sleep without CPAP once per week or more. Most (83%) participants claimed that they were receiving four or more hours of CPAP therapy per night. For the sub-group with reduced CPAP compliance, the most significant factors which influenced use are mask discomfort (50%) and relief of daytime symptoms (63%).
Conclusion: This study demonstrated that CPAP users who met the criteria for adequate adherence to treatment may still have periods of sleep when they were exposed to disease triggering apnoeic episodes. The research in future should compare the long-term benefits of CPAP on morbidity and mortality between groups with perfect and partial compliance with treatment.
Keywords: CPAP; Sleep apnoea; Compliance
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Simpson L, Hillman DR, Cooper MN, Ward KL, Hunter M, et al. High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls. Sleep and Breathing, (2013); 17(3): 967-973.
Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. The Lancet, (2014); 383(9918): 736-747.
Dewan NA, Nieto FJ, Somers VK. Intermittent hypoxemia and OSA: implications for comorbidities. Chest, (2015); 147(1): 266-274.
Manuel A, Hardinge M. Obstructive sleep apnoea. Medicine, (2012); 40(6): 287-292.
Gottlieb DJ, Yenokyan G, Newman AB, O'Connor GT, Punjabi NM, et al. Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation, (2010); 122(4): 352-360.
Yang D, Liu Z, Yang H, Luo Q. Effects of continuous positive airway pressure on glycemic control and insulin resistance in patients with obstructive sleep apnea: a meta-analysis. Sleep and Breathing, (2013); 17(1): 33-38.
Kwon Y, Koene RJ, Johnson AR, Lin G-M, Ferguson JD. Sleep, sleep apnea and atrial fibrillation: questions and answers. Sleep medicine reviews, (2018); 39134-142.
Young T, Finn L, Peppard PE, Szklo-Coxe M, Austin D, et al. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep, (2008); 31(8): 1071-1078.
Farrell PC, Richards G. Recognition and treatment of sleep-disordered breathing: an important component of chronic disease management. Journal of translational medicine, (2017); 15(1): 1-12.
Olaithe M, Bucks RS, Hillman DR, Eastwood PR. Cognitive deficits in obstructive sleep apnea: insights from a meta-review and comparison with deficits observed in COPD, insomnia, and sleep deprivation. Sleep medicine reviews, (2018); 3839-49.
Kendzerska TB, Smith PM, Brignardello-Petersen R, Leung RS, Tomlinson GA. Evaluation of the measurement properties of the Epworth sleepiness scale: a systematic review. Sleep medicine reviews, (2014); 18(4): 321-331.
McDaid C, Durée KH, Griffin SC, Weatherly HL, Stradling JR, et al. A systematic review of continuous positive airway pressure for obstructive sleep apnoea–hypopnoea syndrome. Sleep medicine reviews, (2009); 13(6): 427-436.
Batool‐Anwar S, Goodwin JL, Kushida CA, Walsh JA, Simon RD, et al. Impact of continuous positive airway pressure (CPAP) on quality of life in patients with obstructive sleep apnea (OSA). Journal of sleep research, (2016); 25(6): 731-738.
Barbé Illa F, Durán-Cantolla J, Sánchez de la Torre M, Martínez Alonso M, Carmona C, et al. Effect of Continuous Positive Airway Pressure on the Incidence of Hypertension and Cardiovascular Eventsin Nonsleepy Patients With Obstructive Sleep Apnea. JAMA, 2013, vol 307, núm 20, p 2161-2168, (2013).
Jennum P, Tønnesen P, Ibsen R, Kjellberg J. Obstructive sleep apnea: effect of comorbidities and positive airway pressure on all-cause mortality. Sleep medicine, (2017); 3662-66.
Yu J, Zhou Z, McEvoy RD, Anderson CS, Rodgers A, et al. Association of positive airway pressure with cardiovascular events and death in adults with sleep apnea: a systematic review and meta-analysis. Jama, (2017); 318(2): 156-166.
Guo J, Sun Y, Xue L-J, Huang Z-Y, Wang Y-S, et al. Effect of CPAP therapy on cardiovascular events and mortality in patients with obstructive sleep apnea: a meta-analysis. Sleep and Breathing, (2016); 20(3): 965-974.
Sawyer AM, Gooneratne NS, Marcus CL, Ofer D, Richards KC, et al. A systematic review of CPAP adherence across age groups: clinical and empiric insights for developing CPAP adherence interventions. Sleep medicine reviews, (2011); 15(6): 343-356.
Campos-Rodriguez F, Martinez-Alonso M, Sanchez-de-la-Torre M, Barbe F, Network SS. Long-term adherence to continuous positive airway pressure therapy in non-sleepy sleep apnea patients. Sleep medicine, (2016); 171-6.
Lamberts M, Nielsen OW, Lip GY, Ruwald MH, Christiansen CB, et al. Cardiovascular risk in patients with sleep apnoea with or without continuous positive airway pressure therapy: follow‐up of 4.5 million Danish adults. Journal of internal medicine, (2014); 276(6): 659-666.
Stanchina ML, Welicky LM, Donat W, Lee D, Corrao W, et al. Impact of CPAP use and age on mortality in patients with combined COPD and obstructive sleep apnea: the overlap syndrome. Journal of Clinical Sleep Medicine, (2013); 9(8): 767-772.
Engleman HM, Martin SE, Douglas NJ. Compliance with CPAP therapy in patients with the sleep apnoea/hypopnoea syndrome. Thorax, (1994); 49(3): 263-266.
Sforza E, Roche F. Chronic intermittent hypoxia and obstructive sleep apnea: an experimental and clinical approach. Hypoxia, (2016); 499.
Javaheri S, Barbe F, Campos-Rodriguez F, Dempsey JA, Khayat R, et al. Sleep apnea: types, mechanisms, and clinical cardiovascular consequences. Journal of the American College of Cardiology, (2017); 69(7): 841-858.
Ponto J. Understanding and Evaluating Survey Research. Journal of the advanced practitioner in oncology, (2015); 6(2): 168-171.
Epstein LJ, Kristo D, Strollo PJ, Jr., Friedman N, Malhotra A, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med, (2009); 5(3): 263-276.
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