The Science Journal of the American Association for Respiratory Care

2006 OPEN FORUM Abstracts

SATISFACTION AND PREDICTING FACTORS ON CPAP THERAPY FOR OBSTRUCTIVE SLEEP APNEA IN A SINGAPORE POPULATION

Nancy Lew, RRT; Hairul Borhan, RPSGT; Anne Hsu, MBBS; Constance Lo, MBBS.  Singapore General Hospital, Republic of Singapore.

Introduction: Continuous Positive Airway Pressure (CPAP) treatment is the gold standard treatment for patients with obstructive sleep apnea. However, compliance with CPAP therapy is usually suboptimal.

Aim: To evaluate patient's satisfaction with CPAP therapy in patients with obstructive sleep apnea and to identify any predictive factors towards long term CPAP use. 

Methods: Patients who were being reviewed while on CPAP therapy in the sleep disorders clinic at a university affiliated teaching hospital from October 2005 to March 2006 were asked to fill up a CPAP questionnaire. The questionnaire include questions on patient's demographic data, type of CPAP (fixed pressure or AutoCPAP) machine, duration of CPAP use, Epworth Sleepiness Scale (ESS), their satisfaction with CPAP therapy and to identify factors that will affect long term CPAP use.

Results: 103 patients were enrolled, 85.4% were males; 80.6% were Chinese, 7.6% Malays, 9.7%Indians and 1.9% Eurasians. Mean ± SD AHI was 46.8 ± 25/hr of sleep; age, 51.5 ± 11.7 years; and body mass index, 29.7 ± 6.2 kg/m2. Median duration of CPAP use was 10 months and mean duration of self reported CPAP use per night is 6.1 ± 1.5 hr. 53.4% of the population use a fixed pressure CPAP machine and the rest used auto titrating CPAP machines.

77.7% reported an overall satisfaction with the CPAP therapy and of this group, 87.5% of them use CPAP daily. There are no correlation between satisfaction of CPAP therapy with gender, age, AHI, BMI, source of referral, type of mask used, type of machine used and the prescribed pressure. Subjects who are satisfied with CPAP therapy had a longer duration of use each night (p=0.01), use CPAP for longer period of time (p<0.001) and a lower ESS (p=0.01). Discomfort with airway pressures (p<0.001) and nasal complications (p=0.04) are factors that are identified that correlate with satisfaction with CPAP and long term CPAP use. Mask fitting, brand of machine, technical support and intensive CPAP counseling do not correlate with satisfaction with CPAP nor predict long term CPAP usage.

Conclusion: This study indicates that patients are generally satisfied with CPAP therapy. Patients who are satisfied with CPAP have a longer duration of nightly use, longer period of time using CPAP and lower ESS. Satisfaction with CPAP therapy is associated with better tolerance and no nasal complications. Thus, by ensuring that patients tolerate CPAP therapy and have no nasal complications will lead to long term use of CPAP and improve compliance with CPAP therapy. 

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