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Somnologie

, Volume 20, Issue 2, pp 106–112 | Cite as

Comparison of CPAP adherence in two European sleep centres

Influence of different obstructive sleep apnoea management strategies
  • Ingo FietzeEmail author
  • Jaakko Herrala
  • Olli Polo
  • Martin Glos
  • Alexander Blau
  • Thomas Penzel
Schwerpunkt

Abstract

There is a lack of comparative data on long-term adherence to continuous positive airway pressure (CPAP) therapy in different countries. This study compared data on long-term subjective and objective adherence to CPAP therapy from two sleep research centres, one in Berlin, Germany, the other in Tampere, Finland. The objective was to compare adherence to CPAP therapy in order to identify predictors of good CPAP adherence. Retrospective data from obstructive sleep apnoea(OSA)-patients already undergoing CPAP therapy at sleep centres in Berlin and Tampere were collected. Data included subjective adherence (questionnaire), objective adherence (device data), patient demographics and clinical data. Potential selection bias of patients was carefully checked in both centres. After manual titration, there were significant differences in adherence between patients treated in Berlin (mean 6.14 ± 0.23 h/night) vs. Tampere (mean 4.24 ± 0.24 h/night; p < 0.001). Adherence to CPAP therapy was significantly better in patients with manual titration compared to automatic titration (p < 0.002). Patients tended to overestimate subjective adherence to CPAP. Hypertension has a significant influence on adherence. This study reports significant differences in long-term CPAP therapy adherence between two sleep research centres in different countries for the first time. The differences might result from different management of adverse effects, as well as from variation in the prevalence of comorbid hypertension, titration methods and other patient care procedures.

Keywords

Continuous positive airway pressure CPAP adherence Adverse effects Hypertension Patient care management 

Vergleich der CPAP-Adhärenz zwischen 2 europäischen Schlafzentren

Einfluss von unterschiedlichen Versorgungsstrategien der obstruktiven Schlafapnoe

Zusammenfassung

Bezüglich der Langzeitadhärenz der kontinuierlichen positiven Überdruckbeatmung (CPAP) gibt es bisher wenige vergleichende Untersuchungen zwischen verschiedenen Ländern. In der vorliegenden Studie erfolgt ein Vergleich der subjektiven und der objektiven Langzeitadhärenz der CPAP-Therapie zwischen den Schlafforschungszentren Berlin und Tampere, Finnland, um Prädiktoren für eine gute CPAP-Adhärenz zu bestimmen. Retrospektiv wurden die Daten von CPAP-Patienten, welche sich bereits unter Therapie eines obstruktiven Schlafapnoesyndroms (OSAS) befanden, in den Schlafzentren von Berlin und Tampere erhoben. Diese beinhalteten neben der subjektiven (mittels Fragebogen) und objektiven Adhärenz (Gerätedaten) auch die demographischen sowie klinische Daten. In beiden Zentren erfolgte eine gründliche Untersuchung eines potenziellen Selektionsbias der Patienten. Bei Patienten, welche eine manuelle CPAP-Titration erhalten hatten, wurde eine signifikant unterschiedliche mittlere Adhärenz zwischen den Zentren Berlin (6,14 ± 0,23 h/Nacht) und Tampere (4,24 ± 0,24 h/Nacht; p < 0,001) ermittelt. CPAP-Patienten mit manueller Titration wiesen eine signifikant höhere Adhärenz gegenüber automatischer Titration auf (p < 0,002). Die Patienten neigten in ihrer subjektiven Einschätzung dazu, ihre CPAP-Adhärenz zu überschätzen. Ein bestehender Hypertonus hatte einen signifikanten Einfluss auf die Adhärenz. In dieser Studie wurde zum ersten Mal nachgewiesen, dass sich die Langzeitadhärenz zwischen 2 Schlafforschungszentren verschiedener Länder unterscheidet. Die Ergebnisse können darin begründet sein, dass das Management unerwünschter Wirkungen unterschiedlich ist oder auch dass es Variationen in der Prävalenz einer Hypertonie als Komorbidität, bei den Titrationsmethoden und anderen Verfahren in der Patientenversorgung zwischen den Zentren gibt.

Schlüsselwörter

Kontinuierliche positive Überdruckbeatmung CPAP-Adhärenz Unerwünschte Wirkungen Hypertonie Patientenversorgung 

Notes

Funding

TP was supported partially by the project no. LQ1605 from the National Program of Sustainability II (MEYS CR) and by the project FNUSA-ICRC no. CZ.1.05/1.1.00/02.0123 (OP VaVpI).

Compliance with ethical guidelines

Conflict of interest

I. Fietze, J. Herrala, O. Polo, M. Glos, A. Blau and T. Penzel state that there are no conflicts of interest.

The present study was approved by the Ethics Committees at both study centres and conducted in accordance with good clinical practice (GCP) guidelines.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Ingo Fietze
    • 1
    Email author
  • Jaakko Herrala
    • 2
  • Olli Polo
    • 3
  • Martin Glos
    • 1
  • Alexander Blau
    • 1
  • Thomas Penzel
    • 1
    • 4
  1. 1.Centre for Sleep Medicine, Interdisziplinäres Schlafmedizinisches Zentrum CCM-CC11Charité–Universitätsmedizin BerlinBerlinDeutschland
  2. 2.Medical Imaging Center and Hospital PharmacyTampere University HospitalTampereFinland
  3. 3.Department of Respiratory MedicineUniversity of Tampere and Tampere University HospitalTampereFinland
  4. 4.International Clinical Research CenterSt. Anneʼs University Hospital BrnoBrnoCzech Republic

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