Predictors of Adherence with Positive Airway Pressure Treatment in Patients with Obstructive Sleep Apnea in Korean

ABSTRACT

BACKGROUND AND OBJECTIVES: Application of automatic positive airway pressure (APAP) is regarded as the primary therapy for patients with obstructive sleep apnea syndrome (OSAS). However, a low adherence rate is a major problem with APAP treatment in OSAS patients. Therefore, the aim of the present study is to assess factors related to good adherence of APAP therapy in OSAS Korean patients. MATERIALS AND METHOD: Of 112 consecutive newly diagnosed moderate to severe OSAS patients, 70 were enrolled in this study. All patients received APAP therapy for 2 weeks, along with reinforcing intervention, consisting of motivational reinforcement and technical support. All APAP therapy involved a device rental service. After 2 weeks of treatment, patients had to choose the kind of treatment for OSAS [APAP therapy (good adherence) or alternative treatment options (poor adherence)]. RESULTS: After 6 months, the adherence rate to APAP therapy was 35.7% (n=25). No statistically significant difference was observed between the good and poor adherence groups with regard to snoring intensity, apnea-hypopnea index, and mean O2 saturation after adjusting for age, sex, body mass index, marital status, and socioeconomic status. However, we found that excessive daytime sleepiness and lowest O2 saturation were significantly associated with good adherence [adjusted odds ratios (ORs)=9.515 and 2.327] after adjusting for age, sex, body mass index, marital status, and socioeconomic status. CONCLUSION: Our findings suggest that excessive daytime sleepiness and lowest O2 saturation are important factors to identify good adherence to APAP treatment in Korean OSAS patients.