Assessment of the impact on compliance of a new CPAP system in obstructive sleep apnea

Alison J Wimms, Glenn N Richards, Adam V Benjafield, Alison J Wimms, Glenn N Richards, Adam V Benjafield

Abstract

Background: Despite the efficacy of continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea (OSA), compliance with therapy remains suboptimal.The aim of this study was to determine whether the use of S9TM increased compliance in established CPAP users.

Methods: Subjects with OSA (50) were recruited into the study. When subjects entered the study, 28 days of respective compliance data were downloaded from the patient's usual CPAP device. Subjects trialled the S9 CPAP for 28 days.Subjects then resumed use of their usual CPAP for 28 days.Compliance data from the patient's usual CPAP pre- and post-trialling S9 were compared with data from the S9 CPAP.

Results: Patients were significantly more compliant when using the S9 than their usual CPAP device both pre- and post-S9 based on average daily usage. CPAP pre-S906.58±1.95(mean hours±SD), S907.08±1.18 h and CPAP post-S906.71±1.72 h. The difference between CPAP pre-S9 and S9 was 0.5 h (p00.003). The difference between S9 and CPAP post-S9 was 0.35 h (p00.01). There was no significant difference between CPAP pre-S9 and CPAP post-S9 (p00.34).Patients also completed questionnaires comparing the S9 system to their usual device. Subjective feedback showed a strong preference for the S9.

Conclusions: Participants were significantly more compliant when using the S9 than their usual CPAP device both pre and post-S9 use

Trial registration: ClinicalTrials.gov NCT01013207.

Figures

Fig. 1
Fig. 1
Flow chart
Fig. 2
Fig. 2
Distribution of average daily usage
Fig. 3
Fig. 3
Average daily usage of participants with p-value < 0.05
Fig. 4
Fig. 4
Average usability scores of the S9 and the patient's usual CPAP

References

    1. Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Javier Nieto F, O'Connor GT, Boland LL, Schwartz JE, Samet JM. Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med. 2001;163(1):19–25.
    1. He J, Kryger MH, Zorick FJ, Conway W, Roth T. Mortality and apnea index in obstructive sleep apnea. Experience in 385 male patients. Chest. 1988;94(1):9–14. doi: 10.1378/chest.94.1.9.
    1. Buchner NJ, Sanner BM, Borgel J, Rump LC. Continuous positive airway pressure treatment of mild to moderate obstructive sleep apnea reduces cardiovascular risk. Am J Respir Crit Care Med. 2007;176(12):1274–1280. doi: 10.1164/rccm.200611-1588OC.
    1. Campos-Rodriguez F, Pena-Grinan N, Reyes-Nunez N, De la Cruz-Moron I, Perez-Ronchel J, De la Vega-Gallardo F, Fernandez-Palacin A. Mortality in obstructive sleep apnea–hypopnea patients treated with positive airway pressure. Chest. 2005;128(2):624–633. doi: 10.1378/chest.128.2.624.
    1. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea–hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365(9464):1046–1053.
    1. Avlonitou E, Kapsimalis F, Varouchakis G, Vardavas CI, Behrakis P (2011) Adherence to CPAP therapy improves quality of life and reduces symptoms among obstructive sleep apnea syndrome patients. Sleep Breath
    1. Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc. 2008;5(2):173–178. doi: 10.1513/pats.200708-119MG.
    1. Smith I, Lasserson TJ (2009) Pressure modification for improving usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea. Cochrane Database Syst Rev (4):CD003531
    1. Ruhle KH, Franke KJ, Domanski U, Nilius G. Quality of life, compliance, sleep and nasopharyngeal side effects during CPAP therapy with and without controlled heated humidification. Sleep Breath. 2011;15(3):479–485. doi: 10.1007/s11325-010-0363-2.
    1. Xu T, Li T, Wei D, Feng Y, Xian L, Wu H, Xu J (2011) Effect of automatic versus fixed continuous positive airway pressure for the treatment of obstructive sleep apnea: an up-to-date meta-analysis. Sleep Breath
    1. Dolan DC, Okonkwo R, Gfullner F, Hansbrough JR, Strobel RJ, Rosenthal L. Longitudinal comparison study of pressure relief (C-Flex) vs. CPAP in OSA patients. Sleep Breath. 2009;13(1):73–77. doi: 10.1007/s11325-008-0199-1.
    1. Marshall NS, Neill AM, Campbell AJ. Randomised trial of compliance with flexible (C-Flex) and standard continuous positive airway pressure for severe obstructive sleep apnea. Sleep Breath. 2008;12(4):393–396. doi: 10.1007/s11325-008-0189-3.
    1. Massie CA, Hart RW, Peralez K, Richards GN. Effects of humidification on nasal symptoms and compliance in sleep apnea patients using continuous positive airway pressure. Chest. 1999;116(2):403–408. doi: 10.1378/chest.116.2.403.
    1. Vennelle M, White S, Riha RL, Mackay TW, Engleman HM, Douglas NJ. Randomized controlled trial of variable-pressure versus fixed-pressure continuous positive airway pressure (CPAP) treatment for patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) Sleep. 2010;33(2):267–271.
    1. Massie CA, McArdle N, Hart RW, Schmidt-Nowara WW, Lankford A, Hudgel DW, Gordon N, Douglas NJ. Comparison between automatic and fixed positive airway pressure therapy in the home. Am J Respir Crit Care Med. 2003;167(1):20–23. doi: 10.1164/rccm.200201-022OC.
    1. Nolan GM, Doherty LS, Mc Nicholas WT. Auto-adjusting versus fixed positive pressure therapy in mild to moderate obstructive sleep apnoea. Sleep. 2007;30(2):189–194.
    1. Aloia MS, Stanchina M, Arnedt JT, Malhotra A, Millman RP. Treatment adherence and outcomes in flexible vs standard continuous positive airway pressure therapy. Chest. 2005;127(6):2085–2093. doi: 10.1378/chest.127.6.2085.
    1. Nilius G, Happel A, Domanski U, Ruhle KH. Pressure-relief continuous positive airway pressure vs constant continuous positive airway pressure: a comparison of efficacy and compliance. Chest. 2006;130(4):1018–1024. doi: 10.1378/chest.130.4.1018.
    1. Wenzel M, Kerl J, Dellweg D, Barchfeld T, Wenzel G, Kohler D. Expiratory pressure reduction (C-Flex Method) versus fix CPAP in the therapy for obstructive sleep apnoea. Pneumologie. 2007;61(11):692–695. doi: 10.1055/s-2007-980075.
    1. Leidag M, Hader C, Keller T, Meyer Y, Rasche K. Mask leakage in continuous positive airway pressure and C-Flex. J Physiol Pharmacol. 2008;59(Suppl 6):401–406.
    1. Marquez-Baez C, Paniagua-Soto J, Castilla-Garrido JM. Treatment of sleep apnea syndrome with CPAP: compliance with treatment, its efficacy and secondary effects. Rev Neurol. 1998;26(151):375–380.

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