Age- and gender-related differences of CPAP acceptance for obstructive sleep apnea syndrome in Taiwan
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In our previous study, we observed younger OSAS patients had higher CPAP acceptance but similar compliance as older OSAS patients, suggesting gender factor might play an important role on CPAP acceptance. Hence, we aimed to evaluate the influences of both gender and age on CPAP acceptance and compliance in Taiwanese OSAS patients. This retrospective study included 371 subjects which were subdivided by gender and age (younger: age < 55 years, and older: age ≥ 55 years) (n = 24 for younger women, n = 67 for older women, n = 131 for younger men; and n = 149 for older men). Anthropometric parameters, blood pressures, Epworth sleepiness scale, polysomnography variables, CPAP acceptance, and CPAP compliance were collected and compared. Univariate analysis evaluated the influence of different variables on CPAP acceptance. Due to the presence of multicollinearity for N3 sleep and AHI, as well as N3 sleep and DI, multivariate logistic regression models were conducted using three different models with N3 sleep, AHI, and DI included separately. Univariate analysis found women had less CPAP acceptance than men. Multivariate logistic regression analysis indicated younger women had lower CPAP acceptance, but in contrast younger men had higher CPAP acceptance. No difference was observed among the four subgroups for long-term CPAP compliance. In conclusion, our findings suggest that both age and gender impact CPAP acceptance for treating OSAS in Taiwan, with women having lower CPAP acceptance than men regardless of age. No apparent influence of age and gender on CPAP compliance was observed.
KeywordsObstructive sleep apnea syndrome Continuous positive airway pressure Acceptance Compliance Age Gender
Coronary artery disease
Continuous positive airway pressure
Diastolic blood pressure
Excessive daytime sleepiness
Epworth sleepiness scale
Mean arterial pressure
Obstructive sleep apnea syndrome
Rapid eye movement
Systolic blood pressure
Compliance with ethical standards
Literature search: CCL and WLS; data collection: YCH and MCY; study design: MCY and YKW; analysis of data: MCY; manuscript preparation: YCH and MCY; review of manuscript: YKW and MCY. All authors read and approved the study.
The study was supported by a grant from the Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (TCRD-TPE-106-RT-1).
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
The study was performed in accordance with the Declaration of Helsinki. The Institutional Review Board of the Taipei Tzuchi Hospital approved the protocol.
Since the study was retrospective in design, informed consent was not necessary.
- 8.Neikrug AB, Liu L, Avanzino JA, Maglione JE, Natarajan L, Bradley L, et al. Continuous positive airway pressure improves sleep and daytime sleepiness in patients with Parkinson disease and sleep apnea. Sleep. 2014; 37:177–85.Google Scholar
- 9.Barbe F, Duran-Cantolla J, Sanchez-de-la-Torre M, Martinez-Alonso M, Carmona C, Barcelo A, et al. Effect of continuous positive airway pressure on the incidence of hypertension and cardiovascular events in nonsleepy patients with obstructive sleep apnea: a randomized controlled trial. JAMA. 2012;307:2161–8.CrossRefPubMedGoogle Scholar
- 12.Schwab RJ, Badr SM, Epstein LJ, Gay PC, Gozal D, Kohler M, et al. An official American Thoracic Society statement: continuous positive airway pressure adherence tracking systems. The optimal monitoring strategies and outcome measures in adults. Am J Respir Crit Care Med. 2013; 188: 613 – 20.Google Scholar
- 13.Simon-Tuval T, Reuveni H, Greenberg-Dotan S, Oksenberg A, Tal A, Tarasiuk A. Low socioeconomic status is a risk factor for CPAP acceptance among adult OSAS patients requiring treatment. Sleep. 2009; 32: 545 – 52.Google Scholar
- 15.Hoy CJ, Vennelle M, Kingshott RN, Engleman HM, Douglas NJ. Can intensive support improve continuous positive airway pressure use in patients with the sleep apnea/hypopnea syndrome?. Am J Respir Crit Care Med. 1999; 159: 1096–100.Google Scholar
- 16.Shahrabani S, Tzischinsky O, Givati G, Dagan Y. Factors affecting the intention and decision to be treated for obstructive sleep apnea disorder. Sleep Breath. 2014; 18: 857–68.Google Scholar
- 24.Pelletier-Fleury N, Rakotonanahary D, Fleury B. The age and other factors in the evaluation of compliance with nasal continuous positive airway pressure for obstructive sleep apnea syndrome. A Cox’s proportional hazard analysis. Sleep Med. 2001; 2:225–32.Google Scholar
- 26.Jordan AS, McEvoy RD. Gender differences in sleep apnea: epidemiology, clinical presentation and pathogenic mechanisms. Sleep Med Rev. 2003; 7: 377–89.Google Scholar
- 27.Chen NH, Johns MW, Li HY, Chu CC, Liang SC, Shu YH, et al. Validation of a Chinese version of the Epworth sleepiness scale. Qual Life Res. 2002; 11: 817–21.Google Scholar
- 28.Rechtschaffen A KA. A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. Bethesda, MD: National Institutes of Health; 1968.Google Scholar
- 32.Shapiro GK, Shapiro CM. Factors that influence CPAP adherence: an overview. Sleep Breath. 2010; 14: 323–35.Google Scholar