LONG-TERM COMPLIANCE WITH CPAP THERAPY IN OBSTRUCTIVE SLEEP-APNEA PATIENTS AND IN SNORERS

A prospective study aimed at objectively evaluating compliance with na sal continuous positive airway pressure (CPAP) treatment was conducted in 728 obstructive sleep apnea [OSA; apnea/hypopnea index (AHI) >15 e vents/hour] patients and 98 nonapneic snorers (AHI less than or equal to 15 events/hour). Five-hundred seventy-five OSA patients and 33 nona pneic snorers underwent CPAP therapy and were followed-up for an avera ge of 1,176 +/- 38 days (27 to 4,203 days). Compliance to treatment wa s measured by the mean rate of use of the CPAP device obtained from a built-in time counter. Acceptance of treatment was measured using Kapl an-Meier's model. The acceptance of CPAP was greater than 90% at 3 yea rs and greater than 85% at 7 years in OSA patients. It was greater tha n 60% at 3 years in nonapneic snorers. The mean rate of CPAP use was 5 .7 +/- 1.8 hours/day in OSA patients and 5.6 +/- 1.4 hours/day in snor ers who were still on CPAP on October 1, 1995. It was correlated posit ively with age, body mass index, and AHI, and it was correlated negati vely with daytime partial pressure of oxygen (PaO2), forced expiratory volume in 1 second (FEV(1)), and vital capacity in the group of OSA p atients. This study shows that CPAP therapy is reasonably accepted by OSA patients as well as by nonapneic snorers. Both within and between groups, objective disease severity (as measured by the respiratory eve nt index and daytime and nighttime hyperemia), rather than patients' s ymptoms or complaints, seemed to play a role in the quality of complia nce to treatment.