Factors Affecting Adherence to Continuous Positive Airway Pressure in Thai Patients With Obstructive Sleep Apnea

Abstract

Background and Objective Continuous positive airway pressure (CPAP) compliance significantly affects clinical outcomes in patients with obstructive sleep apnea (OSA). This study aimed to determine the prevalence of CPAP adherence and factors affecting non-adherence in OSA patients. Methods A cross-sectional study was conducted in adult OSA patients undergoing CPAP treatment. CPAP adherence (defined as usage ≥4 hours/night for ≥70% of nights) at 2 weeks, 4 weeks, 3 months, and 6 months was recorded. Patients were categorized into two groups: adherence and non-adherence. Results A total of 210 patients (60.5% male) were included, with mean age of 53.5±14.8 years and mean body mass index of 30.7±6.9 kg/m2. Comorbidities included hypertension (63%) and coronary heart disease (18%). Polysomnographic data showed apnea-hypopnea index of 48.9±32.0 events/hour and nadir saturation of 79.3%±11.4%. Severe OSA was present in 68% of cases. The proportion of CPAP adherence in 2 weeks, 4 weeks, 3 months, and 6 months was 59.1%, 60.0%, 57.6%, and 56.8%, respectively. The factors associated with CPAP non-adherence included removing the mask at night, irregular sleep time, lack of time to use CPAP, dry mouth, and doctor follow-up schedule of more than 6 months. Furthermore, patients who exhibited good adherence at 2 weeks also demonstrated significantly good compliance at 4 weeks, 3 months, and 6 months. Conclusions Only about half of OSA patients had good adherence to CPAP. Various factors influenced CPAP adherence. Patients who exhibited good compliance in the short term were likely to maintain it over the long term.

Keywords

• adult
• continuous positive airway pressure
• sleep apnea