Nasal continuous positive airway pressure (CPAP) has been demonstrated to be highly effective in the elimination of nocturnal upper airway occlusion in the obstructive sleep apnea (OSA) syndrome. Daytime hypersomnolence can be reversed and the long-term cardiopulmonary sequelae of sleep apnea can often be eliminated with nasal CPAP. Long-term patient compliance with this modality has been reported to be excellent in several reports. Sanders et al analyzed long-term home nasal CPAP therapy in somewhat greater detail. They analyzed the number of nights per week and the fraction of nightly sleep time during which the device was used in a group of 24 patients and found an excellent long-term compliance rate of 75 percent. No differences were detected between compliant and noncompliant patients in reported daytime sleepiness, sleep apnea index, or degree of improvement while receiving nasal CPAP Krieger and Kurtz attempted to objectively measure long-term compliance by using a built-in time counter on the nasal CPAP device. They reported an acceptance rate of greater than 90 percent in 46 patients with OSA over a mean follow-up period of approximately eight months.
In this study, we have reviewed our experience over a three-year period in a larger group of patients with OSA referred to our sleep center for nasal CPAP trials and found a somewhat lower overall long-term compliance rate with this modality. Presenting symptoms and sleep studies in compliant and noncompliant patients with OSA were compared in an attempt to identify predictors of long-term compliance, guide patient selection, and plan treatment strategies. cheap viagra professional