Miscellaneous

European Archives of Oto-Rhino-Laryngology

, Volume 264, Issue 9, pp 1081-1086

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Acceptance and long-term compliance of nCPAP in obstructive sleep apnea

  • Wietske RichardAffiliated withDepartment of Otolaryngology/Head and Neck Surgery, St. Lucas Andreas Hospital Email author 
  • , Jantine VenkerAffiliated withDepartment of Otolaryngology/Head and Neck Surgery, St. Lucas Andreas Hospital
  • , Cindy den HerderAffiliated withDepartment of Otolaryngology/Head and Neck Surgery, St. Lucas Andreas Hospital
  • , Dennis KoxAffiliated withDepartment of Otolaryngology/Head and Neck Surgery, St. Lucas Andreas Hospital
  • , Bob van den BergAffiliated withDepartment of Pulmonology, St. Lucas Andreas Hospital
  • , Martin LamanAffiliated withDepartment of Clinical Neurophysiology, St. Lucas Andreas Hospital
  • , Harm van TinterenAffiliated withDepartment of Biostatistics, St. Lucas Andreas Hospital
  • , Nico de VriesAffiliated withDepartment of Otolaryngology/Head and Neck Surgery, St. Lucas Andreas Hospital

Abstract

In a retrospective cohort study, we evaluated whether improvements in nasal continuous positive airway pressure (nCPAP) technology, particularly the introduction of automatic adjustment of the nCPAP pressure (auto-CPAP), have led to better acceptance and (long-term) compliance in patients with obstructive sleep apnea syndrome (OSAS) as compared to earlier reported data. Questionnaires were sent to 256 patients, who were referred to our clinic for an overnight polysomnography from January 1997 to July 2005 and received nCPAP therapy for OSAS. Of the 256 patients, 24 patients were unavailable for follow-up. Of the remaining 232 patients, 58 patients (25%) had discontinued therapy, while 174 patients (75%) were still using nCPAP after 2 months to 8 years of follow-up. One Hundred and thirty eight (79%) of these 174 patients used nCPAP for at least 4 h/night during ≥ 5 nights/week, 82,1% of the conventional nCPAP (fixed pressure CPAP) group (n = 78) and 77,1% of the auto-CPAP group (n = 96). Therefore, including the 58 failures, only 59.5% of patients can be seen as compliant. There were no statistical differences between the fixed pressure CPAP and auto-CPAP users, and between the compliant and non-compliant users according to age, BMI, AHI and Epworth sleepiness scale (ESS). Auto-CPAP patients used significantly more cm H2O. The long-term compliance of nCPAP therapy has have increased only slightly since the introduction of the fixed pressure CPAP 25 years ago, in spite of many efforts to improve it. It seems that a plateau has been reached and that it is unrealistic to aim at a substantially higher compliance rate.

Keywords

Obstructive sleep apnea syndrome Nasal continuous positive airway pressure Compliance