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. 1994 Mar;49(3):263–266. doi: 10.1136/thx.49.3.263

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

H M Engleman 1, S E Martin 1, N J Douglas 1
PMCID: PMC1021157  PMID: 8202884

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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  1. Carskadon M. A., Dement W. C., Mitler M. M., Roth T., Westbrook P. R., Keenan S. Guidelines for the multiple sleep latency test (MSLT): a standard measure of sleepiness. Sleep. 1986 Dec;9(4):519–524. doi: 10.1093/sleep/9.4.519. [DOI] [PubMed] [Google Scholar]
  2. Cheshire K., Engleman H., Deary I., Shapiro C., Douglas N. J. Factors impairing daytime performance in patients with sleep apnea/hypopnea syndrome. Arch Intern Med. 1992 Mar;152(3):538–541. [PubMed] [Google Scholar]
  3. Cramer J. A., Mattson R. H., Prevey M. L., Scheyer R. D., Ouellette V. L. How often is medication taken as prescribed? A novel assessment technique. JAMA. 1989 Jun 9;261(22):3273–3277. [PubMed] [Google Scholar]
  4. Davies R. J., Stradling J. R. The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome. Eur Respir J. 1990 May;3(5):509–514. [PubMed] [Google Scholar]
  5. Dompeling E., Van Grunsven P. M., Van Schayck C. P., 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. doi: 10.1093/fampra/9.2.161. [DOI] [PubMed] [Google Scholar]
  6. Douglas N. J., Thomas S., Jan M. A. Clinical value of polysomnography. Lancet. 1992 Feb 8;339(8789):347–350. doi: 10.1016/0140-6736(92)91660-z. [DOI] [PubMed] [Google Scholar]
  7. Engleman H. M., Cheshire K. E., Deary I. J., Douglas N. J. Daytime sleepiness, cognitive performance and mood after continuous positive airway pressure for the sleep apnoea/hypopnoea syndrome. Thorax. 1993 Sep;48(9):911–914. doi: 10.1136/thx.48.9.911. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Fitzpatrick M. F., Martin K., Fossey E., Shapiro C. M., Elton R. A., Douglas N. J. Snoring, asthma and sleep disturbance in Britain: a community-based survey. Eur Respir J. 1993 Apr;6(4):531–535. [PubMed] [Google Scholar]
  9. Gould G. A., Whyte K. F., Rhind G. B., Airlie M. A., Catterall J. R., Shapiro C. M., Douglas N. J. The sleep hypopnea syndrome. Am Rev Respir Dis. 1988 Apr;137(4):895–898. doi: 10.1164/ajrccm/137.4.895. [DOI] [PubMed] [Google Scholar]
  10. Horn C. R., Clark T. J., Cochrane G. M. Compliance with inhaled therapy and morbidity from asthma. Respir Med. 1990 Jan;84(1):67–70. doi: 10.1016/s0954-6111(08)80097-2. [DOI] [PubMed] [Google Scholar]
  11. Kribbs N. B., Pack A. I., Kline L. R., Smith P. L., Schwartz A. R., Schubert N. M., Redline S., Henry J. N., Getsy J. E., Dinges D. F. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis. 1993 Apr;147(4):887–895. doi: 10.1164/ajrccm/147.4.887. [DOI] [PubMed] [Google Scholar]
  12. 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] [Google Scholar]
  13. Mawhinney H., Spector S. L., Kinsman R. A., Siegel S. C., Rachelefsky G. S., Katz R. M., Rohr A. S. Compliance in clinical trials of two nonbronchodilator, antiasthma medications. Ann Allergy. 1991 Apr;66(4):294–299. [PubMed] [Google Scholar]
  14. Peat J. K., Haby M., Spijker J., Berry G., Woolcock A. J. Prevalence of asthma in adults in Busselton, Western Australia. BMJ. 1992 Nov 28;305(6865):1326–1329. doi: 10.1136/bmj.305.6865.1326. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Thorpy M. J. 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. doi: 10.1093/sleep/15.3.268. [DOI] [PubMed] [Google Scholar]
  16. Whyte K. F., Allen M. B., Jeffrey A. A., Gould G. A., Douglas N. J. Clinical features of the sleep apnoea/hypopnoea syndrome. Q J Med. 1989 Jul;72(267):659–666. [PubMed] [Google Scholar]
  17. 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. doi: 10.1056/NEJM199304293281704. [DOI] [PubMed] [Google Scholar]

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