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1 From the Department of Medicine, Brown University School of Medicine, and the Pulmonary and Critical Care Division, Providence Veterans Affairs Medical Center, Providence, Rl.
Study objectives: To determine an effective means of improving compliance with nasal continuous positive airway pressure (CPAP) for obstructive sleep apnea (OSA).
Design: Retrospective chart review.
Setting: An outpatient clinic at a Veterans Affairs Medical Center.
Patients: Seventy-three patients with OSA.
Interventions: Hour meters on CPAP machines provided documentation of nightly machine use. A 2-h group CPAP clinic, scheduled every 6 months, provided education, support, symptom treatment, and equipment monitoring for all CPAP patients.
Results: Twenty-five patients had hour meter readings taken at their first CPAP clinic. In these patients, nightly CPAP use increased from 5.2±0.6 to 6.3±0.6 h per night after attendance at one CPAP clinic (p<0.05). CPAP use increased from 5.2±0.5 before CPAP clinic to 6.3±0.6 h per night after attendance at all subsequent CPAP clinics for 34 patients (p<0.05), an improvement that was sustained over 605±34 days. Twenty-nine percent of patients increased nightly CPAP use by at least 2 h, while only 6% decreased by 
2 h (p<0.025). Patients receiving supplemental oxygen had higher CPAP use prior to CPAP clinic compared to patients not receiving oxygen (p<0.05).
Conclusions: Attendance in a group clinic designed to encourage patient compliance with CPAP therapy provided a simple and effective means of improving treatment of OSA.
Key Words: compliance • CPAP (continuous positive airway pressure) • obstructive sleep apnea
Submitted on April 29, 1996
Accepted on January 15, 1997
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