Compliance with CPAP therapy in patients with the sleep apnoea/hypopnoea syndrome.

BACKGROUND--Continuous positive airway pressure (CPAP) therapy is the treatment of choice for the sleep apnoea/hypopnoea syndrome. Compliance with this relatively obtrusive therapy has not been well studied. METHODS--Usage of CPAP was investigated in 54 patients with sleep apnoea/hypopnoea syndrome (median 36 (range 7-129) apnoeas + hypopnoeas/hour slept) over the first 1-3 months after starting CPAP therapy. In all cases CPAP usage was monitored by hidden time clocks that indicated for how long the machines were switched on--that is, the CPAP run time. In 32 patients the time at which the CPAP mask pressure was at the therapeutic level of CPAP pressure set for that patient--that is, the mask time--was also monitored. In all patients objective daytime sleepiness was assessed by multiple sleep latency before and after CPAP therapy. RESULTS--The mean (SE) nightly CPAP run time was 4.7 (0.4) hours. There was no correlation between run time and severity of the sleep apnoea/hypopnoea syndrome as assessed by apnoea + hypopnoea frequency or multiple sleep latency, and no correlation between CPAP usage and improvement in multiple sleep latency. Thirty two patients in whom mask time was recorded had therapeutic CPAP pressures for 89% (3%) of their CPAP run times. Patients who experienced side effects from CPAP used their CPAP machines significantly less than those who did not. CONCLUSIONS--Patients with sleep apnoea/hypopnoea syndrome used CPAP for less than five hours/night on average with no correlation between severity of sleep apnoea/hypopnoea syndrome and CPAP usage. Patients who complained of side effects used their CPAP therapy less. It is recommended that, as a minimum, CPAP run time should be regularly recorded in all patients receiving CPAP therapy.

[1]  J. Stradling,et al.  The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome. , 1990, The European respiratory journal.

[2]  N J Douglas,et al.  Factors impairing daytime performance in patients with sleep apnea/hypopnea syndrome. , 1992, Archives of internal medicine.

[3]  C. Shapiro,et al.  Snoring, asthma and sleep disturbance in Britain: a community-based survey. , 1993, The European respiratory journal.

[4]  C. Zwillich,et al.  Nasal CPAP: an objective evaluation of patient compliance. , 1994, American journal of respiratory and critical care medicine.

[5]  N J Douglas,et al.  Clinical features of the sleep apnoea/hypopnoea syndrome. , 1989, The Quarterly journal of medicine.

[6]  C. van Weel,et al.  Treatment with inhaled steroids in asthma and chronic bronchitis: long-term compliance and inhaler technique. , 1992, Family practice.

[7]  T. Young,et al.  The occurrence of sleep-disordered breathing among middle-aged adults. , 1993, The New England journal of medicine.

[8]  S. Spector,et al.  Compliance in clinical trials of two nonbronchodilator, antiasthma medications. , 1991, Annals of allergy.

[9]  A I Pack,et al.  Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. , 1993, The American review of respiratory disease.

[10]  I. Deary,et al.  Daytime sleepiness, cognitive performance and mood after continuous positive airway pressure for the sleep apnoea/hypopnoea syndrome. , 1993, Thorax.

[11]  J. Cramer,et al.  How often is medication taken as prescribed? A novel assessment technique. , 1989, JAMA.

[12]  T. Clark,et al.  Compliance with inhaled therapy and morbidity from asthma. , 1990, Respiratory medicine.

[13]  M. Thorpy.  The clinical use of the Multiple Sleep Latency Test. The Standards of Practice Committee of the American Sleep Disorders Association. , 1992, Sleep.

[14]  N J Douglas,et al.  The sleep hypopnea syndrome. , 1988, The American review of respiratory disease.

[15]  AdrianJ Williams,et al.  Clinical value of polysomnography , 1992, The Lancet.

[16]  A. Woolcock,et al.  Prevalence of asthma in adults in Busselton, Western Australia. , 1992, BMJ.

[17]  J. Krieger,et al.  Objective measurement of compliance with nasal CPAP treatment for obstructive sleep apnoea syndrome. , 1988, The European respiratory journal.

[18]  M. Carskadon,et al.  Guidelines for the multiple sleep latency test (MSLT): a standard measure of sleepiness. , 1986, Sleep.

[19]  N. Douglas,et al.  Clinical value of polysomnography , 1992, The Lancet.