Compliance

Sleep therapy compliance

Compliance with positive airway pressure therapy for obstructive sleep apnea (OSA) is very high, between 80%-88%.1-3 The improvement in compliance over the last few years can be largely attributed to:

  • Improvements in mask design, which have made masks more comfortable4
  • Greater provision of support (education, troubleshooting, coping strategies) to CPAP users (especially new users)5-8
  • Minimization of mouth leak (which causes nasal congestion, nasal dryness, and sore throat in up to 40% of CPAP patients9 and 100% of NPPV patients10 by means of heated humidification11, 12—or a full face mask13
  • For patients requiring higher treatment pressure, the use of ResMed AutoSet devices14

References

  1. Sin DD, Mayers I, Man GC, Pawluk L. Long-term compliance rates to continuous positive airway pressure in obstructive sleep apnea: a population-based study. Chest 2002;121(2):430-5
  2. Pepin JL, Krieger J, Rodenstein D, Cornette A, Sforza E, Delguste P, Deschaux C, Grillier V, Levy P. Effective compliance during the first 3 months of continuous positive airway pressure. A European prospective study of 121 patients.   Am J Respir Crit Care Med 1999;160(4):1124-9.
  3. 3. Kalan A, Kenyon GS, Seemungal TA, Wedzicha JA. Adverse effects of nasal continuous positive airway pressure therapy in sleep apnoea syndrome.  J Laryngol Otol 1999;113(10):888-92.
  4. Smith et al. Sleep 2003; 26(Sup.) A: 406-407.
  5. Lewis KE, Seale L, Bartle IE, Watkins AJ, Ebden P.  Early predictors of CPAP use for the treatment of obstructive sleep apnea. Sleep 2004;27(1):134-8.
  6. Stepnowsky CJ Jr, Bardwell WA, Moore PJ, Ancoli-Israel S, Dimsdale JE. Psychologic correlates of compliance with continuous positive airway pressure. Sleep 2002;25(7):758-62.
  7. Popescu G, Latham M, Allgar V, Elliott MW. Continuous positive airway pressure for sleep apnoea/hypopnoea syndrome: usefulness of a 2 week trial to identify factors associated with long term use. Thorax 2001;56(9):727-33.
  8. Chervin RD, Theut S, Bassetti C, Aldrich MS.  Compliance with nasal CPAP can be improved by simple interventions.  Sleep 1997;20(4):284-89.
  9. Richards GN, Cistulli PA, Ungar RG, Berthon-Jones M, Sullivan CE.  Am J Respir Crit Care Med 1996;154(1):182-186.
  10. Meyer TJ, Pressman MR, Benditt J, McCool FD, Millman RP, Natarajan R, Hill NS.Air leaking through the mouth during nocturnal nasal ventilation: effect on sleep quality. Sleep 1997;20(7):561-569.
  11. Rakotonanahary D, Pelletier-Fleury N, Gagnadoux F, Fleury B. Predictive factors for the need for additional humidification during nasal continuous positive airway pressure therapy. Chest 2001;119(2):460-465.
  12. Massie CA, Hart RW, Peraliz K, Richards GN. Effects of humidification on nasal symptoms and compliance in sleep apnea patients using continuous positive airway pressure. Chest 1999;116(2):403-408.
  13. Martins De Araujo MT, Vieira SB, Vasquez EC, Fleury B. Heated humidification or face mask to prevent upper airway dryness during continuous positive airway pressure therapy. Chest 2000;117(1):142-147 Comment in: Chest 2000;117(3):617-9.
  14. Massie CA, McArdle N, Hart RW, Schmidt-Nowara WW, Lankford A, Hudgel DW, Gordon N, Douglas NJ. Comparison between automatic and fixed positive airway pressure therapy in the home. Am J Respir Crit Care Med 2003;167(1):20-3.