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Depression may reduce adherence during CPAP titration trial.

Mandy Law1, Matthew Naughton1, Sally Ho1

  • 1Alfred Hospital, Prahran, Melbourne, Victoria, Australia and Monash University, Clayton, Victoria, Australia.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|February 18, 2014
PubMed
Summary
This summary is machine-generated.

Depression is linked to lower adherence in autotitrating continuous positive airway pressure (autoPAP) therapy. Addressing depression may improve patient compliance with autoPAP treatment for sleep apnea.

Keywords:
Obstructive sleep apneaadherencecontinuous positive airway pressuredepression

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Area of Science:

  • Sleep Medicine
  • Psychiatry
  • Respiratory Medicine

Background:

  • Depression is a known risk factor for medication non-compliance.
  • Optimizing adherence to positive airway pressure (PAP) therapy is crucial for managing obstructive sleep apnea (OSA).

Purpose of the Study:

  • To investigate the association between depression and adherence to home-based autotitrating continuous positive airway pressure (autoPAP) titration in patients with OSA.

Main Methods:

  • A mixed retrospective-observational study was conducted at an academic center.
  • Two hundred forty OSA patients, new to PAP therapy, underwent home-based autoPAP titration.
  • Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS), with depression defined as a score ≥ 8.

Main Results:

  • Mean autoPAP use was 4.5 ± 2.4 hours per night over approximately one week of titration.
  • Multiple linear regression indicated that depression independently predicted lower autoPAP usage (R(2) = 0.19, p < 0.001).
  • Lower 95th percentile pressures also predicted lesser autoPAP use, potentially confounded by milder OSA severity.

Conclusions:

  • Depression is significantly associated with poorer adherence during autoPAP titration.
  • Targeting depression in OSA patients may be a key strategy to enhance autoPAP therapy adherence.
  • Further research should explore interventions for depression to improve PAP compliance.