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Thorax. 1994 March; 49(3): 263–266.
PMCID: PMC1021157

Compliance with CPAP therapy in patients with the sleep apnoea/hypopnoea syndrome.

Abstract

BACKGROUND--Continuous positive airway pressure (CPAP) therapy is the treatment of choice for the sleep apnoea/hypopnoea syndrome. Compliance with this relatively obtrusive therapy has not been well studied. METHODS--Usage of CPAP was investigated in 54 patients with sleep apnoea/hypopnoea syndrome (median 36 (range 7-129) apnoeas + hypopnoeas/hour slept) over the first 1-3 months after starting CPAP therapy. In all cases CPAP usage was monitored by hidden time clocks that indicated for how long the machines were switched on--that is, the CPAP run time. In 32 patients the time at which the CPAP mask pressure was at the therapeutic level of CPAP pressure set for that patient--that is, the mask time--was also monitored. In all patients objective daytime sleepiness was assessed by multiple sleep latency before and after CPAP therapy. RESULTS--The mean (SE) nightly CPAP run time was 4.7 (0.4) hours. There was no correlation between run time and severity of the sleep apnoea/hypopnoea syndrome as assessed by apnoea + hypopnoea frequency or multiple sleep latency, and no correlation between CPAP usage and improvement in multiple sleep latency. Thirty two patients in whom mask time was recorded had therapeutic CPAP pressures for 89% (3%) of their CPAP run times. Patients who experienced side effects from CPAP used their CPAP machines significantly less than those who did not. CONCLUSIONS--Patients with sleep apnoea/hypopnoea syndrome used CPAP for less than five hours/night on average with no correlation between severity of sleep apnoea/hypopnoea syndrome and CPAP usage. Patients who complained of side effects used their CPAP therapy less. It is recommended that, as a minimum, CPAP run time should be regularly recorded in all patients receiving CPAP therapy.

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Selected References

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  • Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993 Apr 29;328(17):1230–1235. [PubMed]
  • Peat JK, Haby M, Spijker J, Berry G, Woolcock AJ. Prevalence of asthma in adults in Busselton, Western Australia. BMJ. 1992 Nov 28;305(6865):1326–1329. [PMC free article] [PubMed]
  • Fitzpatrick MF, Martin K, Fossey E, Shapiro CM, Elton RA, Douglas NJ. Snoring, asthma and sleep disturbance in Britain: a community-based survey. Eur Respir J. 1993 Apr;6(4):531–535. [PubMed]
  • Horn CR, Clark TJ, Cochrane GM. Compliance with inhaled therapy and morbidity from asthma. Respir Med. 1990 Jan;84(1):67–70. [PubMed]
  • Dompeling E, Van Grunsven PM, Van Schayck CP, Folgering H, Molema J, Van Weel C. Treatment with inhaled steroids in asthma and chronic bronchitis: long-term compliance and inhaler technique. Fam Pract. 1992 Jun;9(2):161–166. [PubMed]
  • Mawhinney H, Spector SL, Kinsman RA, Siegel SC, Rachelefsky GS, Katz RM, Rohr AS. Compliance in clinical trials of two nonbronchodilator, antiasthma medications. Ann Allergy. 1991 Apr;66(4):294–299. [PubMed]
  • Whyte KF, Allen MB, Jeffrey AA, Gould GA, Douglas NJ. Clinical features of the sleep apnoea/hypopnoea syndrome. Q J Med. 1989 Jul;72(267):659–666. [PubMed]
  • Gould GA, Whyte KF, Rhind GB, Airlie MA, Catterall JR, Shapiro CM, Douglas NJ. The sleep hypopnea syndrome. Am Rev Respir Dis. 1988 Apr;137(4):895–898. [PubMed]
  • Douglas NJ, Thomas S, Jan MA. Clinical value of polysomnography. Lancet. 1992 Feb 8;339(8789):347–350. [PubMed]
  • Carskadon MA, Dement WC, Mitler MM, Roth T, Westbrook PR, Keenan S. Guidelines for the multiple sleep latency test (MSLT): a standard measure of sleepiness. Sleep. 1986 Dec;9(4):519–524. [PubMed]
  • Engleman HM, Cheshire KE, Deary IJ, Douglas NJ. Daytime sleepiness, cognitive performance and mood after continuous positive airway pressure for the sleep apnoea/hypopnoea syndrome. Thorax. 1993 Sep;48(9):911–914. [PMC free article] [PubMed]
  • Thorpy MJ. The clinical use of the Multiple Sleep Latency Test. The Standards of Practice Committee of the American Sleep Disorders Association. Sleep. 1992 Jun;15(3):268–276. [PubMed]
  • Cheshire K, Engleman H, Deary I, Shapiro C, Douglas NJ. Factors impairing daytime performance in patients with sleep apnea/hypopnea syndrome. Arch Intern Med. 1992 Mar;152(3):538–541. [PubMed]
  • Cramer JA, Mattson RH, Prevey ML, Scheyer RD, Ouellette VL. How often is medication taken as prescribed? A novel assessment technique. JAMA. 1989 Jun 9;261(22):3273–3277. [PubMed]
  • Krieger J, Kurtz D. Objective measurement of compliance with nasal CPAP treatment for obstructive sleep apnoea syndrome. Eur Respir J. 1988 May;1(5):436–438. [PubMed]
  • Davies RJ, Stradling JR. The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome. Eur Respir J. 1990 May;3(5):509–514. [PubMed]

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