Patterns of nightly CPAP usage in OSA patients with suboptimal treatment adherence

• Published in: Sleep medicine 2020-10, Vol.74, p.109-115
• Main Authors: Grewe, Fabian A., Bradicich, Matteo, Gaisl, Thomas, Roeder, Maurice, Thiel, Sira, Sievi, Noriane A., Kohler, Malcolm
• Format: Article
• Language: English
• Subjects: Adherence; Continuous positive airway pressure; Obstructive sleep apnoea; Usage-patterns
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2020.05.042

Low adherence impairs the effectiveness of continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnoea (OSA), but knowledge on CPAP usage micro-patterns is mostly lacking. Thus, the aim of this study was to analyse usage micro-patterns among patients with suboptimal CPAP adherence. We analysed CPAP usage datasets comprising the initial 31 nights of therapy. By employing a threshold of 4 h usage in at least 70% of nights, we subdivided the patients into suboptimal and optimal users. We investigated single CPAP start- and stop-points, and introduced the parameter “interruption-rate”, by dividing the amount of therapy interruptions per night by the usage duration per night. This parameter represents the amount of interruptions per 1 h of CPAP usage. Group comparison analysis was performed via t-test, Wilcoxon rank sum-test, and via Chi2-test. We included datasets of 48 suboptimal and 48 optimal users (55.9 ± 11.3 years, 83.3% men) in the analysis. Interruption-rate was significantly higher among suboptimal users, when compared with optimal users (median (quartiles) 0.24 (0.14/0.45) versus 0.15 (0.05/0.28), p