RT Journal Article
SR Electronic
T1 Compliance in sleep apnoea therapy: influence of home care support and pressure mode
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 804
OP 811
DO 10.1183/09031936.00023408
VO 33
IS 4
A1 D. Damjanovic
A1 A. Fluck
A1 H. Bremer
A1 J. Müller-Quernheim
A1 M. Idzko
A1 S. Sorichter
YR 2009
UL http://erj.ersjournals.com/content/33/4/804.abstract
AB Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnoea syndrom (OSAS) but therapy adherence is often low. The hypothesis that CPAP-adherence and clinical outcomes can be improved by either using an autoadjusting-CPAP (APAP) device or an intensive support was tested. A controlled parallel group study was performed with 100 newly diagnosed OSAS patients, randomised into 4 groups (n = 25 each): standard or intensive support plus either 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 9 months, intensively supported patients returned for follow-up in 88 versus 68% in the standard-support-group. Daily usage (mean±sem 5.7±0.2 for intensive support versus 4.6±0.4 h for standard support), percentage of days used (80.4±2.8 versus 57.0±5.9%) and proportion of individual sleep time (80.6±3.2 versus 64.9±6.2%) were also higher. There was no significant difference between APAP or CPAP, (daily usage 5.2±0.4 versus 5.1±0.3 h, percentage of days 67.9±5.0 versus 69.2±4.9%, proportion of sleep time 72.5±5.0% versus 72.1±5.2%, for APAP and CPAP) but retention rate was higher with CPAP. In summary, intensive support after continuous positive airway pressure initiation, rather than the application of autoadjusting-continuous positive airway pressure, increased therapy adherence.