Effects of intensive outpatient training on the adherence of CPAP therapy for patients with OSA A randomised trial

• Published in: Somnologie : Schlafforschung und Schlafmedizin = Somnology : sleep research and sleep medicine Vol. 16; no. 4; pp. 251 - 256
• Main Authors: Nilius, G., Cottin, U., Domanski, U., van’t Hoog, T., Franke, K.-J., Burian, S., Ruehle, K.-H.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.12.2012; Springer
• Subjects: Biological and medical sciences; Cardiology; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Fundamental and applied biological sciences. Psychology; Internal Medicine; Medical sciences; Medicine; Medicine & Public Health; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Nervous system (semeiology, syndromes); Neurology; Originalien; Otorhinolaryngology; Pneumology/Respiratory System; Psychology; Sleep. Vigilance; Vertebrates: nervous system and sense organs; Adherence; Obstructive sleep apnoea; CPAP; Continuous positive airway pressure; Education; Schulung; Obstruktive Schlafapnoe; Intensive training programme; Adhärenz; Intensiven Schulung; Night; Telephone; Clock; Prospective; Rest; Positive pressure; Weekly; Sleep wake cycle; Ambulatory; Diagnosis; Hospital; Neurological disorder; Human; Nervous system diseases; Sleep apnea syndrome; Respiratory disease; Sleep disorder; Long term; Rejection; Sleep; Treatment; Environment
• ISSN: 1432-9123; 1439-054X
• DOI: 10.1007/s11818-012-0580-y

Background Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea (OSA). Long-term adherence is still an unsolved problem in this treatment, although different technical modifications for pressure application have been introduced. The only proven intervention to increase therapy adherence is an intensive training programme [1]. Subjects and methods Eighty-four patients with the first diagnosis of OSA completed an intensive CPAP education programme during an in-hospital sleep laboratory stay. In this randomised prospective study the patients were treated as usual (control group) or enrolled in an outpatient training programme consisting of additional weekly telephone calls and an outpatient follow-up appointment with personal and technical support after 6 weeks. The mean daily use of CPAP was determined by reading off the internal clock of the devices, and daytime sleepiness was characterised using the Epworth Sleepiness Scale (ESS). Results In all, 22% of the patients rejected the therapy (mean use of less than 1 h per night). For the rest, the mean use of CPAP was 4.6± 2.7 h in the control group and 4.3± 1.8 h in the intervention group (no statistically significant difference). Conclusion After an intensive introduction to CPAP therapy in an inpatient environment, no increase in therapy adherence could be achieved via weekly telephone calls and a follow-up appointment.