Evaluation of continuous positive airway pressure adherence and its contributing factors.

Background: Continuous positive airway pressure (CPAP) adherence may vary based on the study design and country.
Objectives: To investigate long-term CPAP adherence and elucidate associated factors.
Methods: A multicenter retrospective observational cohort study was conducted over two years. The study included patients diagnosed with obstructive sleep apnea who were prescribed CPAP (n = 1261). Adherence was assessed for 90 days and 365 days. Centers for Medicare and Medicaid Services (CMS) criteria (≥4 h/night on ≥70 % of nights) and research adherence criteria (≥4 h/night during the observational period) were used. Factors influencing CPAP adherence (CMS criteria) during 90 and 365 days were also evaluated. Continuous variables were categorized into low, middle, and high classes, and logistic regression analysis with interaction was performed.
Results: CPAP adherence to CMS criteria for 90 and 365 days was 45.6 % and 44.7 %, respectively, whereas adherence to research criteria was 57.0 % and 54.1 %, respectively. Middle age, high age, and high apnea ratio independently increased CPAP adherence. Conversely, a high rapid eye movement apnea-hypopnea index ratio decreased CPAP adherence. Although high body mass index (BMI) had no independent effect on adherence, its interaction with high 3 % oxygen desaturation index increased 90-day CPAP adherence. However, high BMI decreased 90-day CPAP adherence in males. The interaction between middle age and high BMI was associated with decreased CPAP adherence over 365 days.
Conclusions: Adherence to CPAP in real-world settings is modest. Various factors influence CPAP adherence. BMI may exert varied effects on CPAP adherence depending on the accompanying factors.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Motoo Yamauchi reports a relationship with Sanofi that includes: funding grants. Motoo Yamauchi reports a relationship with Koike Medical Co Ltd that includes: funding grants. Motoo Yamauchi reports a relationship with Murata Manufacturing Co Ltd that includes: consulting or advisory. Motoo Yamauchi reports a relationship with Inspire Medical Systems Inc that includes: consulting or advisory. Azusa Ikegami reports a relationship with Esai Corp that includes: funding grants and speaking and lecture fees. Azusa Ikegami reports a relationship with MSD Corp that includes: funding grants and speaking and lecture fees. Azusa Ikegami reports a relationship with AstraZeneca Corp that includes: funding grants and speaking and lecture fees. Azusa Ikegami reports a relationship with ResMed KK that includes: consulting or advisory. Toshio Takaoka reports a relationship with ResMed KK that includes: consulting or advisory. Ryutaro Shirahama reports a relationship with Sony Music Entertainment Inc that includes: consulting or advisory. Ryutaro Shirahama reports a relationship with XEBIO Holdings Co. that includes: consulting or advisory. Ryutaro Shirahama reports a relationship with Lifenrich. Co. that includes: consulting or advisory. Ryutaro Shirahama reports a relationship with Zone Co Ltd that includes: consulting or advisory. Ryutaro Shirahama reports a relationship with MTG Co Ltd that includes: consulting or advisory and funding grants. Ryutaro Shirahama reports a relationship with Takeda Pharmaceutical Company Limited that includes: speaking and lecture fees. Shigeo Muro reports a relationship with Chugai Pharmaceutical Co Ltd that includes: funding grants. Shigeo Muro reports a relationship with Rohto Pharmaceutical Co Ltd that includes: funding grants. Shigeo Muro reports a relationship with Kintetsu Cable Network Co Ltd that includes: funding grants. Shigeo Muro reports a relationship with Nippon Boehringer Ingelheim Co Ltd that includes: consulting or advisory. Shigeo Muro reports a relationship with Novartis Pharma Japan that includes: consulting or advisory. Shigeo Muro reports a relationship with GSK Japan that includes: consulting or advisory. Shigeo Muro reports a relationship with AstraZeneca Japan that includes: consulting or advisory. Shigeo Muro reports a relationship with Teijin Pharma Limited that includes: consulting or advisory. Shigeo Muro reports a relationship with Janssen Pharmaceutical KK that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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