Acceptance of Treatment Suggestions for Sleep-Disordered Breathing

Abstract

Problem: Sleep-disordered breathing is one of the most widespread diseases in industrialized countries. Unfortunately, even in severe cases, sleep apnea patients often do not follow the treatments suggested. The aim of this study was to investigate (1) the primary acceptance rates in relation to the kind of treatment suggested and (2) whether there are characteristic differences between patients who accept and those who do not accept the treatments recommended.

Methods: In our study, 503 patients with sleep-disordered breathing underwent complete fully attended polysomnography in the sleep lab. With regard to the nature and severity of their sleep disorder and the individual clinical findings, 171 patients were recommended to undergo nCPAP, 42 to use a mandibular advancement device (MAD), and for 244 patients a surgical treatment was suggested. In 21 cases there was no need for any kind of treatment, and in the other 25 cases only weight loss was suggested.

Results: In total, 234 patients accepted the treatment suggested (46.5%). In detail, the recommendations were accepted as follows: nCPAP 54%, surgery 42%, MAD 40.5%, and weight loss 4%. Gender did not have any affect on the acceptance rate. The youngest and the oldest patients showed higher acceptance rates (<24 years 100%, >65 years 62%). In general patients with more severe disease tended to accept treatment more frequently (acceptance rate of 40% for primary snorers vs 85% for patients with severe sleep apnea; P < 0.05).

Conclusion: The acceptance rate of treatment suggestions for sleep-disordered breathing is dependent on the severity of the disease. This may be due to the more pronounced clinical symptoms going along with increasing severity of the disease. The kind of treatment suggested (apart from weight loss) and the age of the patients seem to have only minor influence on the primary acceptance of treatment suggestions, while gender seems to have no effect at all.

Significance: In mild sleep apnea, the consequences of the disease have to be accounted very carefully to the patient in order to achieve the patient's compliance for any kind of treatment.

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