Effects of CPAP Compliance in Obstructive Sleep Apnea Patients at Victory Health Partners

Abstract

Background:

Obstructive sleep apnea (OSA) is the most common cause of nocturnal apnea. CPAP is an effective first-line therapy for OSA. Patient compliance with CPAP remains an issue. This study was done to quantify CPAP compliance, the factors contributing to CPAP use and compliance, and to determine if CPAP has made a change in the variables used to determine the presence of OSA (Berlin questionnaire data) in a sample of uninsured patients at the Victory Health Partners (VHP) clinic in Mobile, Alabama. We hypothesized that there would be a reduction in symptoms with CPAP compliance.

Methods:

All patients treated with CPAP for OSA at the VHP clinic were available for study. After IRB approval, patients who remained in the VHP system were identified for inclusion. An 18-question phone survey was used to gather data about CPAP compliance and symptoms. Responses were quantified using descriptive statistics. Changes in subjects' Berlin Questionnaire Sleepiness score were evaluated using a two-tailed Fisher's Exact test. P < .05 was considered significant.

Results:

Out of 170 patients who have been treated for OSA at VHP clinic, 77 continue as patients and 28 were located and consented to this study. Twenty (71%) of subjects were compliant. Pre-CPAP Berlin questionnaire data were available from 15 patients. Of those patients, snoring, apnea, and daytime tiredness and fatigue were significantly reduced (P=<0.0001, P=0.0169, P=0.0063, respectively). No significant changes in blood pressure or sleeping while driving were found. The reasons reported for noncompliance by those subjects were equipment failure (1), mask discomfort (5), lost weight and no longer have symptoms (1), claustrophobia (2), could not sleep due to system discomfort (2) and dry nose/throat (1).

Conclusions:

When patients with obstructive sleep apnea were compliant with CPAP therapy, symptoms (snoring, apnea, and daytime tiredness and fatigue) were decreased. Noncompliance in patients was primarily caused by mask or system discomfort.

Disclosures:

None.