Compliance in sleep apnoea therapy: influence of home care support and pressure mode

¹ Dept of Pneumology, University Hospital Freiburg, Germany

^* To whom correspondence should be addressed. E-mail: stephan.sorichter{at}uniklinik-freiburg.de.

	Abstract

Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnoea syndrom (OSAS), but therapy adherence is often low. We tested the hypothesis that CPAP-adherence and clinical outcomes can be improved by either using an autoadjustingCPAP (APAP) device or an intensive support.

Controlled parallel group study with 100 newly diagnosed OSAS patients, randomised into 4 groups (n=25): standard or intensive support plus APAP or CPAP. Intensive support included education and monthly home visits for 6 months. Clinical outcome was monitored by polysomnography at CPAP initiation and after 3 and 9 months, compliance data were downloaded from the CPAP devices.

After nine months, intensively-supported patients returned for follow-up in 88% vs 68% in the standard-support-group. Mean daily usage ([mean±SEM] 5.7±0.2h intensive support vs 4.6±0.4h standard support), percentage of days used (80.4±2.8% vs 57.0±5.9%) and proportion of individual sleep time (80.6±3.2% vs 64.9±6.2%) were also higher. There was no significant difference between APAP or CPAP, (daily usage[APAP vs CPAP] 5.2±0.4h vs 5.1±0.3h, percentage of days 67.9±5.0% vs 69.2±4.9%, proportion of sleep time 72.5±5.0% vs 72.1±5.2%), but retention rate was higher with CPAP.

Intensive support after CPAP initiation rather than the application of APAP, increased therapy adherence.