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Compliance in treatment of the sleep apnea syndrome using continuous positive pressure respiration
Authors:K Sonka  KS Hofmannová  V Spalková  M Pretl
Affiliation:Neurologická klinika 1. LF UK a VFN, Praha.
Abstract:BACKGROUND: Continuous positive airway pressure (CPAP) is the therapeutic method of choice in sleep apnoea syndrome (SAS) but involves at first discomfort for the patients. The correct indication, correct setting of the overpressure and good adaptation influence the application and therapeutic asset of CPAP. METHODS AND RESULTS: From a total number of 41 patients with SAS treated by CPAP 24 were examined (incl. three women), who had CPAP in domiciliary treatment for more than two months. The mean period of use was 288.2 days (range 52-824). 84% of the patients used CPAP daily, the mean number of applications per week was 6.26 (range 2-7). For the whole period of sleep CPAP was used by 75% patients and the mean sleep period with CPAP was 6 hours (range 2.5-8). None of the patients discontinued treatment completely. Four patients used CPAP inadequately (less than 25 hours per week) - one because of intolerance associated with severe CHOCHB, the second one for intolerance of overpressure of 15 mbar, the third one because of poor motivation and the fourth one because of dehydration of mucous membranes. All patients recorded the therapeutic effect of CPAP. Rhonchopathy disappeared in 87.5% patients, excessive somnolence improved in 91.7%, fatigue declined in 88.5%. The functional capacity and work performance improved in 95.8% patients. Undesirable effects were not serious nor frequent: escape of air from the mask (29.2%), dry mucosae (20.8%), pressure sores caused by the mask (20.8%), serous rhinitis (12.5%), burning sensation of the mucosae of the upper airways (8.3%) and conjunctivitis (4.2%) CONCLUSIONS: Adequate compliance with CPAP was recorded in 83.3% patients and a favourable effect of treatment was proved.
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