HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (12) Citing Articles via Google Scholar Google Scholar Articles by Aloia, M. S. Articles by Millman, R. P. Search for Related Content PubMed PubMed Citation Articles by Aloia, M. S. Articles by Millman, R. P.

Treatment Adherence and Outcomes in Flexible vs Standard Continuous Positive Airway Pressure Therapy^*

^* From the Department of Psychiatry and Human Behavior (Drs. Aloia and Arnedt), and the Division of Pulmonary, Critical Care, and Sleep Medicine (Drs. Stanchina and Millman), Department of Medicine, Brown Medical School, Providence, RI; and the Division of Sleep Medicine (Dr. Malhotra), Brigham and Women’s Hospital, Boston, MA.

Correspondence to: Mark S. Aloia, PhD, Assistant Professor of Psychiatry, Duncan Building, Butler Hospital, 700 Butler Dr, Providence, RI 02906; e-mail: Mark_Aloia{at}Brown.edu

Study objectives: To compare adherence and clinical outcomes between flexible positive airway pressure (PAP) [C-Flex; Respironics; Murraysville, PA] and standard PAP therapy (ie, continuous positive airway pressure [CPAP]).

Design and setting: A controlled clinical trial of CPAP therapy vs therapy using the C-Flex device in participants with moderate-to-severe obstructive sleep apnea. Participants were recruited from and followed up through an academic sleep disorders center.

Participants: Eighty-nine participants were recruited into the study after they had undergone complete in-laboratory polysomnography and before initiating therapy. Participants received either therapy with CPAP (n = 41) or with the C-Flex device (n = 48), depending on the available treatment at the time of recruitment, with those recruited earlier receiving CPAP therapy and those recruited later receiving therapy with the C-Flex device. Follow-up assessments were conducted at 3 months.

Measurements and results: The groups were similar demographically. The mean (± SD) treatment adherence over the 3-month follow-up period was higher in the C-Flex group compared to the CPAP group (weeks 2 to 4, 4.2 ± 2.4 vs 3.5 ± 2.8, respectively; weeks 9 to 12, 4.8 ± 2.4 vs 3.1 ± 2.8, respectively). Clinical outcomes and attitudes toward treatment (self-efficacy) were also measured. Change in subjective sleepiness and functional outcomes associated with sleep did not improve more in one group over the other. Self-efficacy showed a trend toward being higher at the follow-up in those patients who had been treated with the C-Flex device compared to CPAP treatment.

Conclusions: Therapy with the C-Flex device may improve overall adherence over 3 months compared to standard therapy with CPAP. Clinical outcomes do not improve consistently, but C-Flex users may be more confident about their ability to adhere to treatment. Randomized clinical trials are needed to replicate these findings.

Key Words: continuous positive airway pressure • outcomes • sleep apnea • treatment adherence

This article has been cited by other articles:

				A. Ozsancak, C. D'Ambrosio, and N. S. Hill Nocturnal Noninvasive Ventilation Chest, May 1, 2008; 133(5): 1275 - 1286. [Abstract] [Full Text] [PDF]