@article {Salepci1467, author = {Banu Salepci and Benan Caglayan and Nesrin Kiral and Elif Torun Parmaksiz and Sevda Sener Comert and Gulsen Sarac and Ali Fidan and Gulten Aktin Gungor}, title = {CPAP Adherence of Patients With Obstructive Sleep Apnea}, volume = {58}, number = {9}, pages = {1467--1473}, year = {2013}, doi = {10.4187/respcare.02139}, publisher = {Respiratory Care}, abstract = {BACKGROUND: Continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BPAP) are the gold standard treatments for obstructive sleep apnea syndrome (OSAS), but CPAP/BPAP is not well tolerated and requires long-term follow-up. OBJECTIVE: We prospectively assessed subjective and objective adherence and factors that affect adherence in OSAS patients. METHODS: Subjects using CPAP/BPAP were questioned about adverse effects of CPAP/BPAP and were assessed with the Epworth Sleepiness Scale (ESS) at the first, third, sixth, and twelfth month, and once every 6 months after the first year. CPAP/BPAP use and objective and subjective adherence were assessed. Subjects who used CPAP/BPAP for at least 4 hours per night for at least 70\% of the days monitored were regarded as adherent, and those who did not were considered non-adherent. The relationships between adherence and demographic data, polysomnography findings, ESS scores, and adverse effects were statistically analyzed. RESULTS: Six-hundred forty-eight subjects who were diagnosed with OSAS by polysomnography and accepted to use CPAP/BPAP in our sleep center between January 2005 and June 2011 were included. Four-hundred fifty-one subjects (69.6\%) were men, and 197 (30.4\%) were women. Two-hundred forty-eight (38.3\%) subjects attended follow-ups, 246 (37.9\%) were called by telephone, and 154 (23.8\%) could not be reached. Of the whole population, 63.9\% had obtained their CPAP/BPAP machine. In the 248 subjects who attended follow-ups, subjective adherence was 85.1\% and objective adherence was 64.5\%. Improvement in ESS score (P \< .001) and satisfactory sleep (P \< .001) were found to be significantly higher in the adherent group. Chest discomfort, difficulty falling asleep, and sleep disturbances were significantly higher in the non-adherent group (all P \< .01). CONCLUSIONS: Of the whole population, just 38.3\% attended follow-ups. The objective adherence was lower than the subjective adherence in subjects who attended follow-ups. Younger subjects were more adherent, and the most important factors that correlated with adherence were substantial improvement of daytime sleepiness and effect of CPAP/BPAP on satisfactory sleep. CONCLUSIONS: CPAP/BPAP adherence should be followed with objective monitoring.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/58/9/1467}, eprint = {https://rc.rcjournal.com/content/58/9/1467.full.pdf}, journal = {Respiratory Care} }