Acceptance and long-term compliance with nCPAP in patients with obstructive sleep apnoea syndrome

Previous studies have generally shown poor effective long-term compliance with nasal continuous positive airway pressure (nCPAP) in patients with obstructive sleep apnoea syndrome (OSAS). We performed a retrospective study of patients treated with nCPAP for more than one year. Compliance was defined as the average number of hours of nCPAP use per day, where hours of use were obtained from the built-in time counter of the nCPAP device, after deduction of the 10% difference between effective use and time counters previously shown by others. We present data on the first 95 patients for whom results were available. The follow-up period was 784 +/- 366 (mean +/- SD) days for the whole group. Compliance was 5 +/- 1.8 h. For a subgroup of 36 patients, we had data on two consecutive follow-up periods (673 +/- 235 and 390 +/- 147 days for the first and second period, respectively). Compliance remained stable (5.2 +/- 1.5 and 5 +/- 2.3 h, respectively). For the whole group, a significant correlation was found between compliance and sleep fragmentation expressed as the movement arousal index (r = 0.226). During a similar 3 year period, 155 patients with a confirmed diagnosis of OSAS were offered a nCPAP trial. CPAP was actually delivered for home use to 117 patients (76%). During this same 3 year period, only 21 patients out of a total of 192 followed-up in our institution quit treatment, mainly due to intolerance or cure. These results indicate that in a nonselected group of obstructive sleep apnoea syndrome patients a high and stable compliance with nasal continuous positive pressure can be achieved, contradicting recent results of other series.