Therapy with nCPAP: incomplete elimination of Sleep Related Breathing Disorder

Correct assessment of the overall treatment effectiveness requires knowledg e about therapy compliance and efficacy. This study aimed to determine over all long-term apnoea alleviation after continuous positive airway pressure (CPAP) in a complete sleep laboratory cohort. Out of 209 consecutive CPAP candidates (mean age 57+/-12 yrs, body mass ind ex (BMI) 30.0+/-5.1 kg.m(2), respiratory disturbance index (RDI) 32.9+/-29 h), follow-up treatment was performed in 149 of them at 9, 18 and 30 months after CPAP prescription. Compliance with CPAP (machine run time/days CPAP available) was adjusted for the individual subjective sleep-time. Apnoea al leviation was defined as adjusted compliance multiplied by the CPAP effect (RDI with CPAP applied), remaining RDI was calculated. The baseline RDI, age or BMI in 75 patients, who did not tolerate nasal con tinuous positive airway pressure (nCPAP), did not differ from those accepti ng CPAP (acceptors, n=74). In accepters at 9 months follow-up RDI with CPAP applied was 1.4+/-2.6 (CPAP effect, n=66), mean CPAP use was 3.6+/-2.5.24 h(-1) (n=68), mean apnoea alleviation was 52.4+/-32.0% (range 1-100%, n=47) , the average remaining whole-night RDI was 17.8+/-26. At 9, 18 and 30 mont hs (n=47), the mean daily CPAP use increased from 3.6+/-2.5 h to 4.1+/-2.5 h and 4.4+/-2.4 h (p<0.01). Effectiveness of continuous positive airway pressure is potentially high bu t acceptance was low When accounting for sleep-time, its actual effect and use, only 50% adjusted continuous positive airway pressure effectiveness wa s observed.