PT  - JOURNAL ARTICLE
AU  - Otto D. Schoch
AU  - Florent Baty
AU  - Jolanda Niedermann
AU  - Jochen J. Ruediger
AU  - Martin H. Brutsche
TI  - Predictors of long-term PAP-adherence in obstructive sleep apnea syndrome
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P441
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P441.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P441.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Introduction: Few studies have assessed long-term adherence to positive airway pressure therapy (PAP) in OSAS. The aim of this retrospective study was to determine adherence and its potential predictors.Methods: All patients (pts) treated at the St.Gallen sleep centre from 11/2001 to 4/2011 were included for analysis of baseline data and follow-up information. The primary dependent variable of interest was continued use of PAP. Kaplan-Meier estimates and Cox-proportional hazards regression were used to model the risk of loss of adherence. A multivariate regression analysis was performed for age, gender, Epworth sleepiness score (ESS), BMI, apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) at baseline.Results: During the study period, of 2160 pts started on PAP, 42(2%) died on PAP, 91(4%) no longer needed PAP (weight reduction, alternative treatments) and 311(14%) were lost to follow-up. In 1716 pts, adherence at 1y was 74(95% CI: 71-76)%, at 5y 56(53-59)%, and at 8y 52(49-56)%. Results of univariate and multivariate analyses are summarized in the figure.Conclusion: Adherence is independently associated with clinical (ESS) and polysomnographic (ODI, AHI) measures of OSAS severity, but not with BMI, age, gender. Most pts who stopped PAP were lost to follow-up. With a relatively low long-term adherence, intensified efforts and alternative or novel follow-up options (e.g. telemetry) to support such patients should be tested.