Inadequate compliance of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea-hypopnea syndrom (OSAHS) diagnosis

Background: CPAP during night rest is the first line treatment for OSAHS. However, several factors interfere in its adequate compliance and therefore, affect directly its effectiveness. Our study aim was to analyze most relevant causes of therapeutic noncompliance, as well as possible proposals to mitigate this problem. Methods: we have selected 175 individuals from a tertiary hospital pulmonology clinics whose compliance was lower than 60 minutes daily. We’ve analyzed the follow-up place, subjective treatment compliance, daily treatment hours, possible non-compliance reasons and what proposals improve adherence. We tried to contact these 175 patients by phone to complete a standardized questionnaire. Results: 133 patients were contacted. 9,77% do not develop any follow up. 62.4% admitted inadequate compliance, while the remaining (37.31%) denied it. 47 patients do not use CPAP, 39 use it between 1 and 5 hours, 43 between 6 and 8 hours and 4 more than 8 hours. Most common reasons for non-compliance were: interphase intolerance in 22.5% of patients and absence of clinical improvement in 9%. As a possible proposals, 51 patients suggested to make technical and interface improvements and 16 requested to receive more information about the disease and its treatment. 14 patients preferred to withdraw the CPAP therapy. Conclusion: subjective perception of patients own compliance is not always related to actual compliance. Most relevant measures to reduce inadequate compliance are: technical simplification and ergonomic interface improvements to increase the CPAP tolerance and offer all necessary information related to the disease and its treatment.