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Factors affecting compliance with positive airway pressure therapy in obstructive sleep apnea

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Objective

To investigate the factors affecting compliance with positive airway pressure (PAP) therapy and establish the relationship between compliance and pulmonary function tests (PFT) in patients with OSA.

Material and methods

In this prospective study, patients with OSA using PAP devices were questioned about the complaints related to the device. Depression and anxiety scales along with PFT parameters were also assessed.

Results

Of 98 participants, 63% were men. The mean age was 52.0 ± 9.6 years. Sixty-seven percent of the patients were compliant with their devices. A significant difference was observed between the proportion of the participants compliant or non-compliant with the device, based on OSA severity (p < 0.05). Beck depression inventory (BDI) and Beck anxiety inventory (BAI) scores of the compliant patients were significantly lower than those of the non-compliant patients (p < 0.001, p = 0.044, respectively). No statistically significant difference was detected between the groups regarding individual pulmonary function tests (p > 0.05). The rates of nasal mask use, not having difficulty in tolerating CPAP, falling asleep, absence of abdominal distension, no facial sores, no air leakage, patients benefiting from the device, reduction in daytime sleepiness, and the belief that they are receiving appropriate therapy in participants compliant with the device were higher than those in non-compliant participants (p < 0.05). The rates of claustrophobia and discomfort due to pressure were significantly lower in patients compliant with the device than in the non-compliant patients (p < 0.05).

Conclusion

While no relationship was detected between PFT parameters and PAP therapy compliance, significant factors affecting the device compliance were detected.

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Authors and Affiliations

  1. Department of Chest Diseases, Afyonkarahisar Dinar State Hospital, 03400, Dinar, Afyonkarahisar, Turkey

    Merve Ercelik

  2. Department of Chest Diseases, Faculty of Medicine, Duzce University, Duzce, Turkey

    Ege Gulec Balbay, Pınar Yıldız Gulhan & Peri Meram Arbak

  3. Department of Biostatistics and Medical Informatics, Faculty of Medicine, Duzce University, Düzce, Turkey

    Sengul Cangur

  4. Department of Chest Diseases, Silopi State Hospital, Şırnak, Turkey

    Fuat Aytekin

  5. Department of Chest Diseases, Ünye State Hospital, Ordu, Turkey

    Mehmet Fatih Elverisli

Authors
  1. Merve Ercelik
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  2. Ege Gulec Balbay
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  3. Pınar Yıldız Gulhan
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  4. Sengul Cangur
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  5. Peri Meram Arbak
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  6. Fuat Aytekin
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  7. Mehmet Fatih Elverisli
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Corresponding author

Correspondence to Merve Ercelik.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethics committee approval was received for this study from the ethics committee of Duzce University (2018).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

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Comment

This paper studied the factors affecting compliance with PAP therapy and established the relationship between compliance and pulmonary function tests (PFT) in patients with OSAS.

Since 1989, interest in improving the compliance of treatments for OSAS has been studied.

Although PAP is effective in the treatment of OSAS, inadequate adherence remains one of the main causes of treatment failure, even considering the new advances in the treatment using APAP (Automatic Positive Airway Pressure).

The topic remains of great importance. The assessment of the patient's psychological context can predict difficulties in patient compliance, helping early monitoring of these patients.

The monitoring of patients using PAP by a specialized team in the first 6 months is crucial for solving problems with the objective of increasing adherence and reducing adverse events.

The article presents originality when comparing compliance with psychological aspects, PFT, and other factors.

Luana Souto Barros

Porto, Portugal

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Ercelik, M., Balbay, E.G., Gulhan, P.Y. et al. Factors affecting compliance with positive airway pressure therapy in obstructive sleep apnea. Sleep Breath 26, 725–732 (2022). https://doi.org/10.1007/s11325-021-02447-4

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  • DOI: https://doi.org/10.1007/s11325-021-02447-4

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