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Open Access 01-12-2020 | Sleep Apnea | Sleep Breathing Physiology and Disorders • Original Article

Ten-year adherence to continuous positive airway pressure treatment in patients with moderate-to-severe obstructive sleep apnea

Authors: Matsusato Tsuyumu, Tadao Tsurumoto, Jiro Iimura, Tsuneya Nakajima, Hiromi Kojima

Published in: Sleep and Breathing | Issue 4/2020

Abstract

Purpose

This study aimed to evaluate the 10-year adherence to and identify the predictors of dropout from continuous positive airway pressure (CPAP) treatment for patients with moderate-to-severe obstructive sleep apnea (OSA).

Methods

We retrospectively analyzed the continuity, dropout, or other behaviors of 181 patients who initiated CPAP treatment at the Tokyo Dental College Ichikawa General Hospital from January 2003 to June 2005.

Results

Among a total of 181 patients, 56 (30.9%) dropped out of the treatment. Among the 125 patients who did not dropout, 54 continued CPAP treatment for > 10 years, 16 completed the treatment with OSA improvement, and 7 could not complete the treatment owing to unavoidable reasons such as death, dementia, hospitalization for serious illness, or migration to other countries. Further, 47 patients moved to another facility, whereas 1 patient purchased a CPAP device and stopped visiting our facility. Among the 56 patients who dropped out, approximately 50% of the patients dropped out within a year, and all dropped out within 76 months. Comparing demographics, OSA parameters, and CPAP parameters between the patients who did and did not drop out of the treatment, Cox regression analysis indicated that body mass index (BMI) and the first-month utilization rate were clinical variables that were independently associated with discontinuation of CPAP treatment.

Conclusion

The results of this study show that BMI and the first-month utilization rate of CPAP treatment are the predictors of the long-term adherence to this treatment.

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Benjafield AV, Ayas NT, Eastwood PR, Heinzer R, Ip MS, Morrell MJ, Nunez CM, Patel SR, Penzel T, Pépin JL, Peppard PE, Sinha S, Tufik S, Valentine K, Malhotra A (2019) Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med 7:687–698. https://doi.org/10.1016/S2213-2600(19)30226-7CrossRefPubMedPubMedCentral

Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342:1378–1384. https://doi.org/10.1056/NEJM200005113421901CrossRefPubMed

Barbé F, Durán-Cantolla J, Sánchez-de-la-Torre M, Martínez-Alonso M, Carmona C, Barceló A, Chiner E, Masa JF, Gonzalez M, Marín JM, Garcia-Rio F (2012) Effect of continuous positive airway pressure on the incidence of hypertension and cardiovascular events in nonsleepy patients with obstructive sleep apnea: a randomized controlled trial. JAMA 307:2161–2168. https://doi.org/10.1001/jama.2012.4366CrossRefPubMed

Sánchez-de-la-Torre M, Campos-Rodriguez F, Barbé F (2013) Obstructive sleep apnoea and cardiovascular disease. Lancet Respir Med 1:61–72. https://doi.org/10.1016/S2213-2600(12)70051-6CrossRefPubMed

Jenkinson C, Davies RJ, Mullins R, Stradling JR (1999) Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial. Lancet 353:2100–2105. https://doi.org/10.1016/S0140-6736(98)10532-9CrossRefPubMed

Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, Mullins R, Jenkinson C, Stradling JR, Davies RJ (2002) Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet 359:204–210. https://doi.org/10.1016/S0140-6736(02)07445-7CrossRefPubMed

Antic NA, Catcheside P, Buchan C, Hensley M, Naughton MT, Rowland S, Williamson B, Windler S, McEvoy RD (2011) The effect of CPAP in normalizing daytime sleepiness, quality of life, and neurocognitive function in patients with moderate to severe OSA. Sleep 34:111–119. https://doi.org/10.1093/sleep/34.1.111CrossRefPubMedPubMedCentral

Becker HF, Jerrentrup A, Ploch T, Grote L, Penzel T, Sullivan CE, Peter JH (2003) Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 107:68–73. https://doi.org/10.1161/01.cir.0000042706.47107.7aCrossRefPubMed

Craig SE, Kohler M, Nicoll D, Bratton DJ, Nunn A, Davies R, Stradling J (2012) Continuous positive airway pressure improves sleepiness but not calculated vascular risk in patients with minimally symptomatic obstructive sleep apnoea: the MOSAIC randomised controlled trial. Thorax 67:1090–1096. https://doi.org/10.1136/thoraxjnl-2012-202178CrossRefPubMed

10.

Campos-Rodriguez F, Peña-Griñan N, Reyes-Nuñez N, De la Cruz-Moron I, Perez-Ronchel J, De la Vega-Gallardo F, Fernandez-Palacin A (2005) Mortality in obstructive sleep apnea–hypopnea patients treated with positive airway pressure. Chest 128:624–633. https://doi.org/10.1378/chest.128.2.624CrossRefPubMed

11.

Florés M, Martínez-alonso M, Sánchezde-la-Torre A, Aldomà A, Galera E, Barbé F, Sánchezde-la-Torre M, Dalmases M (2018) Predictors of long-term adherence to continuous positive airway pressure in patients with obstructive sleep apnoea and acute coronary syndrome. J Thorac Dis 10:S124–S134. https://doi.org/10.21037/jtd.2017.12.128CrossRefPubMedPubMedCentral

12.

Lee CHK, Leow LC, Song PR, Li H, Ong TH (2017) Acceptance and adherence to continuous positive airway pressure therapy in patients with obstructive sleep apnea (OSA) in a Southeast Asian privately funded healthcare system. Sleep Sci 10:57–63. https://doi.org/10.5935/1984-0063.20170010CrossRefPubMedPubMedCentral

13.

Luyster FS, Strollo PJ Jr, Thunström E, Peker Y (2017) Long-term use of continuous positive airway pressure therapy in coronary artery disease patients with nonsleepy obstructive sleep apnea. Clin Cardiol 40:1297–1302. https://doi.org/10.1002/clc.22827CrossRefPubMedPubMedCentral

14.

Furukawa T, Suzuki M, Ochiai M, Kawashima H, Yokoyama N, Isshiki T (2014) Long-term adherence to nasal continuous positive airway pressure therapy by hypertensive patients with preexisting sleep apnea. J Cardiol 63:281–285. https://doi.org/10.1016/j.jjcc.2013.08.013CrossRefPubMed

15.

Baratta F, Pastori D, Bucci T, Fabiani M, Fabiani V, Brunori M, Loffredo L, Lillo R, Pannitteri G, Angelico F, Del Ben M (2017) Long-term prediction of adherence to continuous positive air pressure therapy for the treatment of moderate/severe obstructive sleep apnea. Sleep Med 43:66–70. https://doi.org/10.1016/j.sleep.2017.09.032CrossRef

16.

Abdelghani A, Benzarti W, Ben Salem H, Gargouri I, Garrouche A, Hayouni A, Benzarti M (2016) Adherence to treatment with continuous positive airway pressure in the obstructive sleep apnea syndrome. Tunis Med 94:551–562PubMed

17.

Uematsu A, Akashiba T, Kumasawa F, Akahoshi T, Okamoto N, Nagaoka K, Gon Y, Kaneita Y, Uchiyama M, Hashimoto S (2016) Factors influencing adherence to nasal continuous positive airway pressure in obstructive sleep apnea patients in Japan. Sleep Biol Rhythms 14:339–349. https://doi.org/10.1007/s41105-016-0064-8CrossRef

18.

Wang Q, Ou Q, Tian XT, Chen YC, Nie ZQ, Gao XL (2016) Analysis of long-term compliance to continuous positive airway pressure in patients with obstructive sleep apnea. Zhonghua Yi Xue Za Zhi 96:2380–2384. https://doi.org/10.3760/cma.j.issn.0376-2491.2016.30.004CrossRefPubMed

19.

McArdle N, Devereux G, Heidarnejad H, Engleman HM, Mackay TW, Douglas NJ (1999) Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 159:1108–1114. https://doi.org/10.1164/ajrccm.159.4.9807111CrossRefPubMed

20.

Campos-Rodriguez F, Martínez-alonso M, Sánchez-de-la-torre M, Barbé F (2016) Long-term adherence to continuous positive airway pressure therapy in nonsleepy sleep apnea patients. Sleep Med 17:1–6. https://doi.org/10.1164/ajrccm.159.4.9807111CrossRefPubMed

21.

Krieger J, Kurtz D, Petiau C, Sforza E, Trautmann D (1996) Long-term compliance with CPAP therapy in obstructive sleep apnea patients and in snorers. Sleep 19:S136–S143. https://doi.org/10.1093/sleep/19.suppl_9.S136CrossRefPubMed

22.

Kohler M, Smith D, Tippett V, Stradling JR (2010) Predictors of long-term compliance with continuous positive airway pressure. Thorax 65:829–832. https://doi.org/10.1136/thx.2010.135848CrossRefPubMed

23.

Campos-Rodriguez F, Martinez-Garcia MA, Reyes-Nuñez N, Caballero-Martinez I, Almeida-Gonzalez CV, Catalan-Serra P, Peña-Griñan N (2013) Long-term continuous positive airway pressure compliance in females with obstructive sleep apnoea. Eur Respir J 42:1255–1262. https://doi.org/10.1183/09031936.00165812CrossRefPubMed

24.

Rechtschaffen A, Kales A (1968) In: Berger RJ, Dement WC, Jacobson A, Johnson LC, Jouvet M, Monroe LJ, Oswald I, Roffwarg HP, Roth B, Walter RD (eds) A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. Public Health Service, U.S. Government Printing Office, Washington

25.

Parish JM, Lyng PJ, Wisbey J (2000) Compliance with CPAP in elderly patients with OSA. Sleep Med 1:209–214. https://doi.org/10.1016/S1389-9457(00)00011-3CrossRefPubMed

26.

Gray EL, McKenzie DK, Eckert DJ (2017) Obstructive sleep apnea without obesity is common and difficult to treat: evidence for a distinct pathophysiological phenotype. J Clin Sleep Med 13:81–88. https://doi.org/10.5664/jcsm.6394CrossRefPubMedPubMedCentral

27.

Zgierska A, Pietrzyk A, Pływaczewski R, Zieliński J (2000) Compliance to treatment recommendations in patients with obstructive sleep apnea at least one year after diagnosis. Pneumonol Alergol Pol 68:11–20PubMed

28.

Bachour A, Vitikainen P, Maasilta P (2016) Rates of initial acceptance of PAP masks and outcomes of mask switching. Sleep Breath 20:733–738. https://doi.org/10.1007/s11325-015-1292-xCrossRefPubMed

29.

Fleury B, Nguyen XL, Rakotonanahary D, Cohen-Levy J, Pételle B (2009) The set-up of obstructive sleep apnea treatment. Rev Pneumol Clin 65:214–218. https://doi.org/10.1016/j.pneumo.2009.07.002CrossRefPubMed

Title: Ten-year adherence to continuous positive airway pressure treatment in patients with moderate-to-severe obstructive sleep apnea
Authors: Matsusato Tsuyumu
Tadao Tsurumoto
Jiro Iimura
Tsuneya Nakajima
Hiromi Kojima
Publication date: 01-12-2020
Publisher: Springer International Publishing
Keywords: Sleep Apnea
Polysomnography
Published in: Sleep and Breathing / Issue 4/2020
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-020-02033-0

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Ten-year adherence to continuous positive airway pressure treatment in patients with moderate-to-severe obstructive sleep apnea

Abstract

Purpose

Methods

Results

Conclusion

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Abstract

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Conclusion

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