Adherence to treatment with continuous positive airways pressure

• Published in: Revue des maladies respiratoires Vol. 35; no. 5; p. 531
• Main Authors: Ghrairi, H, Khalfallah, I, Abid, N, Loukil, M
• Format: Journal Article
• Language: French
• Published: France 01-05-2018
• Subjects: Adult; Aged; Continuous Positive Airway Pressure - psychology; Continuous Positive Airway Pressure - statistics & numerical data; Female; Follow-Up Studies; Humans; Male; Middle Aged; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Patient Compliance - statistics & numerical data; Sleep Apnea, Obstructive - epidemiology; Sleep Apnea, Obstructive - therapy; Treatment Outcome; Tunisia - epidemiology; Adherence; Obstructive sleep apnea syndrome; Acceptance; Acceptation; Traitement; Syndrome d’apnées obstructives du sommeil; Treatment; Observance; Pression positive continue; Tolerance; Tolérance; Continuous positive Airways pressure
• ISSN: 1776-2588
• DOI: 10.1016/j.rmr.2017.07.024

Continuous positive airways pressure (CPAP) is the standard treatment for obstructive sleep apnea syndrome (OSAS). It produces substantial benefits if used for the appropriate indication and if patients adhere to treatment.
We conducted a prospective study of 103 patients treated with CPAP over four years follow-up.
Our population had a mean age of 52 years with a sex ratio of 0.63. Face to face, individual education was provided in all cases. CPAP titration was performed by an unattended domiciliary autoadjusted CPAP device in 83.5% of patients for 15 days to one month. Twenty patients refused CPAP treatment after the period of titration. Eighty two patients (98.8%) were treated by constant CPAP. Seventy five percent of the patients complained of at least one side effect. The more common were nasal (56.6%) and mask related problems (40%). Seventy six percent of patients used CPAP for more than 4hours per day. Eleven patients stopped CPAP therapy because of intolerance (10 cases) and reluctance to instrumental therapy (one case). Adherence to CPAP therapy was associated with the severity of OSAS, the level of daytime sleepiness, higher pressures, repeated education during the course of follow up, clinical efficacy and the presence of fewer side-effects.
We obtained satisfactory rates of adherence and tolerance of CPAP assisted by regular medical and technical follow-up of patients.