CPAP acceptance and adherence among patients diagnosed with obstructive sleep apnea: A long-term study from eastern India

JOURNAL TITLE: Indian Journal of Sleep Medicine

Author
1. Dhrubajyoti Roy
2. Anupam Patra
3. Aloke Gopal Ghoshal
4. Mita Roy Sengupta
5. Avik Ghoshal
6. Supriya Sarkar
7. Susmita Kundu
ISSN
0973-340X
DOI
10.5958/0974-0155.2015.00004.2
Volume
9
Issue
4
Publishing Year
2014
Pages
7
Author Affiliations
    1. R.G. Kar Medical Collage, Kolkata 700 004, West Bengal, India
    1. College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
    1. Pulmonary Lab/Clinic and Sleep Associated Research Centre, Kolkata, West Bengal
    1. Faculty, National Allergy Asthma Bronchitis Institute, Kolkata.
    1. Residential Medical Officer cum Clinical Tutor, R.G.Kar Medical College, Kolkata.
    1. Junior Faculty, National Allergy Asthma Bronchitis Institute, Kolkata.
    1. Faculty, National Allergy Asthma Bronchitis Institute, Kolkata.
  • Article keywords
    Adherence, Acceptance, Sleep apnea, Obstructive, CPAP.

    Abstract

    Background: Continuous positive airway pressure (CPAP) is considered to be the gold standard for the management of obstructive sleep apnea (OSA). But poor CPAP adherence is the main limiting factor of the OSA treatment. Objectives: To find out the acceptance and adherence of CPAP use in patients with OSA and the association of personal and disease characteristics of the patients with patterns of CPAP use. Methods: A cross-sectional retrospective study was conducted between June 2014 and December 2014 at the PULSAR, a sleep laboratory in Kolkata, India. Patients diagnosed with OSA between July 2007 and June 2011 at the PULSAR were included and analyzed applying a telephonic questionnaire. Results: A total of 523 patients had undergone polysomnography. Of them, 514 (98.3%) patients were prescribed CPAP; 40(7.6%) were dead, and 36 (6.9%) could not be contacted. of the 438 (83.7%) patients contacted over the phone, 25 (4.8%) refused to participate in the study. The rest, that is, 412 (79%) patients, that agreed to be interviewed were divided into three groups-group I: never used CPAP (134, 25.6%);group II: ever used CPAP (27, 5.2%);and group III: currently using CPAP (252, 48.2%). The mean age of the patients was 50.5 ± 11.2 years; the mean body mass index of the group was 30 ± 5.3. The mean apnea–hypopnea index was 62.3 ± 20.1, with a range of 8.5–127.9. The mean duration of use in ever-used group was 21.6 ± 8.4 months and in current-user group was 54.8 ± 16.0 months. Mechanical discomfort (34.3%) is main cause of non-adherence. Conclusion: About one-third patients prescribed CPAP never initiated the treatment, and those who started reported a high incidence of adherence during the period of this study. A significant correlation was observed between disease severity and the duration of CPAP use.

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