CPAP Compliance in Sleep Apnea Patients with and without Laboratory CPAP Titration

Melanie K. Means; Jack D. Edinger; Aatif M. Husain

doi:10.1055/s-2004-822849

Sleep and Breathing, Table of Contents

Sleep Breath 2004; 8(1): 7-14
DOI: 10.1055/s-2004-822849

ORIGINAL ARTICLE

Published by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

CPAP Compliance in Sleep Apnea Patients with and without Laboratory CPAP Titration

Melanie K. Means¹ , Jack D. Edinger¹ ^, ² , Aatif M. Husain¹ ^, ²

¹Department of Veterans Affairs Medical Center, Durham, North Carolina
²Duke University Medical Center, Durham, North Carolina

Abstract

Advances in auto-adjusting positive airway pressure technology for obstructive sleep apnea now permit this treatment to be initiated outside of the sleep laboratory environment, bypassing the need for laboratory-based titration studies. Thus far, little research has addressed how such developments may affect compliance to continuous positive airway pressure (CPAP). We tested the effect of laboratory CPAP exposure and technologist support in a retrospective chart review of 98 veterans with obstructive sleep apnea to determine whether patients who received standard laboratory CPAP titration complied better with CPAP than did patients who received no laboratory CPAP titration. Fifty patients underwent standard technician-attended polysomnography (PSG) with CPAP titration, and 48 patients underwent unattended PSG with no laboratory trial of CPAP (first CPAP exposure was at home). Objective CPAP compliance measures were obtained from CPAP units at follow-up visits. Attended-PSG patients wore CPAP significantly longer per night on average (5.0 hours vs 3.9 hours) and tended to wear CPAP on more nights (76.5% vs 64.2%) compared with unattended-PSG patients. These findings suggest that patients' sleep laboratory experience with CPAP and the support and education provided by sleep technologists are important factors in facilitating CPAP compliance.

KEYWORDS

Continuous positive airway pressure - compliance - obstructive sleep apnea - unattended polysomnography

Full Text

References

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Melanie MeansPh.D.

Psychology Service 116B, VA Medical Center

508 Fulton St.

Durham, NC 27705

Email: mkmeans@duke.edu