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KMID : 1101120230200010062
Journal of Sleep Medicine
2023 Volume.20 No. 1 p.62 ~ p.69
Encouraging Continuous Positive Airway Pressure Adherence With Personalized Strategies
Yoon Jee-Eun

Oh Dan-A
Hwang In-Ha
Lee Woo-Jin
Yun Chang-Ho
Abstract
Objectives: This study aimed to elucidate whether a comprehensive intervention focusing on individual characteristics could enhance adherence to Continuous Positive Airway Pressure (CPAP) in patients with Obstructive Sleep Apnea (OSA).

Methods: We conducted a single-arm, pilot intervention study, recruiting participants aged ¡Ã20 years with suspected OSA. All participants underwent split-night polysomnography and received standardized CPAP treatment. We identified five categories of factors contributing to poor CPAP adherence: mouth breathing, high CPAP pressure causing sleep initiation difficulties, bradypnea or hyperpnea before sleep onset, postarousal central apnea, and nasal dryness and obstruction. We objectively measured CPAP adherence data at 1, 3, 6 and 12 months after a comprehensive intervention targeting individual characteristics. We analyzed the trends in CPAP adherence rates over 1 year.

Results: A total of 48 participants (74.0% males; 56.9¡¾13.9 years old) were followed up for 12 months. CPAP adherence rate was 77.1% at 1 month; declined to 60.4%, 39.6%, and 31.3% at 3, 6, and 12 months, respectively. There was no significant difference in demographic and psychological factors, sleep-related symptoms, and sleep characteristics between the adherence and the non-adherence groups. Low body mass index was an independent risk factor affecting CPAP adherence (odds ratios 0.78, p=0.04).

Conclusions: Although our study did not yield significant improvements in CPAP adherence through the comprehensive intervention that targeted individual characteristics, it is significant because it attempted to provide a multidimensional approach to intervention, rather than targeting a single aspect, in promoting CPAP adherence.
KEYWORD
Obstructive sleep apnea, Continuous positive airway pressure, Compliance, Intervention
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