Adherence to CPAP in patients with obstructive sleep apnea in a Chinese population
Yan Wang1, Weijie Gao, Mei Sun
1Department of Respiratory Medicine, Tianjin Medical University General Hospital, Tianjin, China.
Background:
CPAP is the first choice for most patients with obstructive sleep apnea (OSA), but the adherence to CPAP is suboptimal. The purpose of this study was to assess the adherence to CPAP therapy of Chinese OSA patients with CPAP therapy.
Methods:
Two-hundred ten patients who had been diagnosed with OSA and had experienced CPAP titration trial as prescribed were enrolled in this study. Subjects were identified by reviewing our Snoring and Sleep Apnea Unit's records. The patients were interviewed by telephone and were asked to assess their CPAP use time. Those who said their CPAP use time was less than 4 h/d for 70% of the nights per week were questioned about their reasons for non-adherence.
Results:
Seventeen patients were lost to follow-up. One-hundred ninety-three patients participated in our survey. Patient demographics included male/female (162/31), mean ± SD age (51.91 ± 10.10 y), and mean apnea-hypopnea index (59.99 ± 21.51 events/h). At the time of the interview (59 ± 32 months after initial titration trial), 100 of 193 patients (51.8%) were still using CPAP, 29 of 193 patients (15.0%) had abandoned CPAP after using it for a period, and 64 of 193 patients (33.2%) had never commenced therapy after titration. The most common reasons cited by the patients for the poor adherence were they were not able to acclimatize to the CPAP during the titration night, they did not perceive the need or the benefits of the treatment, or found it troublesome to use CPAP every night.
Conclusions:
The CPAP adherence is low in Tianjin, China. Only one half of these patients remained adherent to the treatment, and the other one half of these patients either never initiated the treatment or had abandoned CPAP use. To improve CPAP adherence, the medical staff should pay attention to making the titration trial a comfortable first CPAP experience for the patients. It is also very important to give the patients education and support about CPAP use in the follow-up, especially early on in this treatment.
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