Factors associated with noncompliance to treatment with positive airway pressure
Ho-Sheng Lin1, Abhishek S Prasad, Chuan-Ju G Pan
1Department of Surgery, John D. Dingell Veterans Affairs Medical Center, Detroit, Mich, USA. hlin@med.wayne.edu
Objective:
To identify risk factors that may predispose patients with a diagnosis of obstructive sleep apnea (OSA) to fail treatment with positive airway pressure (PAP) owing to noncompliance.
Design:
Retrospective medical chart review.
Setting:
Academic tertiary care center.
Patients:
Patients who underwent polysomnography during 2 periods: from March 1999 to July 2001 and from March 2003 to December 2003.
Main Outcome Measures:
Of the 949 patients identified, only 131 patients had complete medical and follow-up records that were adequate for analysis of compliance. Compliance was defined as using PAP for at least 4 hours per night on 70% of the nights monitored. We used chi(2) and logistic regression analyses to assess correlations among PAP compliance and various patient variables as well as among sleep and titration study parameters.
Results:
Of the 131 patients analyzed, 48 patients (37%) were noncompliant with PAP therapy. A statistically significant correlation was found between a low apnea-hypopnea index (AHI) and PAP noncompliance (P = .004).
Conclusions:
In this study, a low AHI was identified as a risk factor for noncompliance with PAP treatment. Therefore, patients with OSA and with a low AHI may warrant closer follow-up to allow early identification of PAP treatment failure owing to noncompliance and to allow timely institution of other treatment modalities, such as surgery.
Related Concept Videos
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation (NIPPV)
01:29Chronic Obstructive Pulmonary Disease-V: Management
Smoking Cessation
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
Assessment
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue, improving...