Subjective factors associated with cpap nonadherence in patients with sleep apnea hypopnea syndrome

Abstract

Introduction: the benefits of CPAP depend on the number of hours being used by the patient. The aim of the study was to establish, in patients with sleep apnea (SAHS), if there is adequate adherence to CPAP and to determine what factors reported by the patient are related to non-adherence. Methods: an analytical observational cross-sectional study in patients treated with CPAP. Good adherence was defined as a minimum of 4 hours use at least 70% of days (device score). Logistic regression analysis to assess factors related to non-adherence: pressure, airway dryness, mask problems and lack of education in the use of CPAP. Results: of 160 patients, 88 (55%) had poor adherence. Age, weight, height, neck and apnea index were similar in the groups with good and poor adherence. The Epworth and CPAP pressure were significantly higher in the group of poor adherence (p <.05). The average hours of use of CPAP in the group with good adherence was 5.1 ± 1.7 hours and the poor adherence group was 1.9 ± 1.5 hours. The patients overestimated the use of CPAP in 2.0 hours: 5.3 hours reported by the patient versus 3.3 hours according to the device card (p <0.001). The only factor reported by the patient that was associated with poor adherence was CPAP pressure (adjusted OR: 3.34 [1.34 to 8.30]). Conclusions: adherence to CPAP in patients with SAHS is suboptimal (poor adherence in 55% of patients). The main cause related to non-adherence according to patients was intolerance to the pressure device. Patients overestimate the real hours of CPAP use