Compliance is often the primary obstacle to CPAP treatment efficacy.
In the early 1990s, many researchers agreed that treatment compliance rates were around 46%.1
The good news from more recent research is that, although patient compliance remains an ongoing challenge, modern technology and practices present a more optimistic picture.
Solutions
Most researchers agree that the best approach to improving compliance is multi-faceted:
- Comfortable, convenient, and reliable equipment
- Education supplied by the healthcare team - a population-based CPAP program consisting of consistent follow-up, "troubleshooting," and regular feedback to both patients and physicians. CPAP compliance rates of >85% over 6 months2
- Active involvement of patient in their own treatment
- Support network available for patient
If appropriate support and education are provided, there are two interventions that may improve compliance:
- Humidification - "Our results demonstrate that heated humidification significantly improves the nCPAP daily rate of use and that its need may be predicted"3
- AutoSet® therapy - “We conclude that among patients requiring higher CPAP (10 cm H2O or more) there are improvements in CPAP use, OSAHS symptoms, and quality of life domains when using auto-titrating (AutoSet) as opposed to fixed pressure CPAP"4
References
- Kribbs NB et al. Objective Measurement of Patterns of Nasal CPAP Use by Patients with Obstructive Sleep Apnea. Am Rev Respir Dis 1993; 147: 887-95.
- Sin Don D et al. Long-term compliance rates to continuous positiveairway pressure in obstructive sleep apnea: a population-based study. Chest (United States) Feb 2002, 121(2) 430-435.
- Rakotonanahary D et al. Heated Humidification significantly improves CPAP daily rate of use. Chest 2001: 460-465.
- Massie Clifford A et al. Comparison between Automatic and Fixed Positive Airway Pressure Therapy in the Home. Am Journal Resp Critical Care Med 2003; 167:20-23.