Long-term use of CPAP in patients with obstructive sleep apnea: a prospective longitudinal cohort study

Continuous positive airway pressure (CPAP) is an efficient treatment for obstructive sleep apnea (OSA). Reports of long-term usage vary, as do the factors that predict long-term usage. The aim of this study was to explore long-term CPAP usage and identify potential predictors. This prospective longitudinal cohort study included all patients referred to an outpatient clinic for CPAP treatment during an eight-month period. Clinical data were collected at baseline. Follow-ups were scheduled after one week, three months and two years. Use data were downloaded from the CPAP device at each follow-up. Of 163 included patients, 112 were available for long-term follow-up 2-4 years after starting CPAP, and use data were downloaded for 99 patients. Median duration of CPAP use was 6 h/night (IQR 4.2-7.1). The only significant variable predicting long-term usage was usage at three months. Nearly half (43%) of the patients needed extra consultations beyond the standard treatment plan. Most patients (69%) did not contact the clinic for their recommended two-year follow-up but were instead called into the clinic specifically for the study. There was no significant difference in long-term CPAP usage between patients who initiated contact themselves and those who were called in and would otherwise have been lost for follow-up. Most patients adhere well to CPAP in the long term, although many need extra follow-up. Patients lost for follow-up should not necessarily be considered non-adherent as their reason for not attending could be that they are managing treatment well on their own.