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* From the Department of Medicine and Therapeutics, Centre for Clinical Trials and Epidemiological Research (Mr. Wong), Prince of Wales Hospital, and Chinese University of Hong Kong (Drs. Hui, Choy, Li, Ko, Chan, and Lai), Shatin, New Territories, Hong Kong.
Correspondence to: David S. C. Hui, MBBS, FCCP, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; e-mail: dschui{at}cuhk.edu.hk
Objective: To assess continuous positive airway pressure (CPAP) compliance and factors associated with CPAP compliance among Chinese patients with obstructive sleep apnea (OSA).
Design: A prospective study of 112 consecutive patients with newly diagnosed OSA commencing CPAP treatment.
Setting: A university teaching hospital.
Measurements and results: The following factors were
evaluated for any correlation with objective CPAP compliance (effective
mask pressure [hours per day]) at 1 month and 3 months: age, baseline
apnea-hypopnea index (AHI), common OSA symptoms, minimum arterial
oxygen saturation (SaO2), mean
SaO2, arousal index (AI), Epworth sleepiness
scale (ESS), education level, CPAP levels, satisfaction with CPAP, side
effects, and machine cost. There were 101 male and 11 female patients,
with a mean (± SD) age of 45.6 ± 1.2 years; body mass index,
29.3 ± 5.2 kg/m2; AI, 60 ± 18/h; AHI, 48 ± 24/h;
minimum SaO2 of 70 ± 17%; and mean
SaO2 of 86 ± 7%. ESS fell from
12.9 ± 4.0 (baseline) to 5.2 ± 4.7 at 3 months (p < 0.001).
Objective CPAP compliance was 5.4 ± 1.6 h/d and 5.3 ± 1.6 h/d,
while 75% and 72% of our patients were using CPAP objectively for
4 h/d and at least 70% of the nights per week at 1 month and 3
months, respectively. Following univariate analysis of variance, a high
baseline AHI (p = 0.006 and p = 0.004) was associated with higher
objective CPAP compliance at 1 month and 3 months, respectively.
Conclusion: CPAP usage and compliance were high in this patient population. A high baseline AHI was the only significant independent predictor of better CPAP compliance.
Key Words: compliance • continuous positive airway pressure • obstructive sleep apnea
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