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Effects of Augmented Continuous Positive Airway Pressure Education and Support on Compliance and Outcome in a Chinese Population^*

^* From the Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.

Correspondence to: David S. C. Hui, MBBS, FCCP, Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; e-mail: dschui{at}cuhk.edu.hk

Objectives: To study the effects of augmentation of continuous positive airway pressure (CPAP) education and support on compliance and outcome in patients with obstructive sleep apnea (OSA).

Design: A randomized, controlled, parallel study of basic vs augmented CPAP education and support.

Setting: A university teaching hospital.

Patients: A total of 108 OSA patients randomized into basic-support (BS) and augmented-support (AS) groups.

Interventions: Patients in the BS group (n = 54) were given educational brochures on OSA and CPAP, CPAP education by nurses, CPAP acclimatization, and were reviewed by physicians and nurses at weeks 4 and 12. Patients in the AS group (n = 54) received more education, including a videotape, telephone support by nurses, and early review at weeks 1 and 2.

Measurements: Objective CPAP compliance, Calgary sleep apnea quality of life index (SAQLI), and cognitive function after 1 month and 3 months; and Epworth sleepiness scale (ESS) after 3 months of CPAP treatment.

Results: At 4 weeks, CPAP usage was 5.3 ± 0.2 h/night (mean ± SEM) vs 5.5 ± 0.2 h/night in the BS and AS groups, respectively (p = 0.4). At 12 weeks, CPAP usage was 5.3 ± 0.3 h/night vs 5.3 ± 0.2 h/night in the two groups, respectively (p = 0.98). There was greater improvement of SAQLI at 4 weeks (p = 0.008) and at 12 weeks (p = 0.047) in the AS group. There was no significant difference between BS and AS groups in terms of improvement of ESS and cognitive function.

Conclusion: Augmentation of CPAP education and support does not increase CPAP compliance, but leads to a greater improvement of quality of life during the reinforced period.

Key Words: compliance • continuous positive airway pressure education • obstructive sleep apnea • outcome

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