FLEXIBLE PAP AND TREATMENT ADHERENCE
Flexible Positive Airway Pressure Improves Treatment Adherence Compared with Auto-adjusting PAP
Yuichi Chihara, MD, PhD1; Tomomasa Tsuboi, M.D, PhD2; Takefumi Hitomi, MD, PhD2; Masanori Azuma, MD1; Kimihiko Murase, MD1; Yoshiro Toyama, MD1; Yuka Harada, MD1; Kensaku Aihara, MD1; Kiminobu Tanizawa, MD1; Tomohiro Handa, MD, PhD3; Chikara Yoshimura, MD, PhD2; Toru Oga, MD, PhD2; Kazuhiko Yamamoto, MD, PhD4; Michiaki Mishima, MD, PhD1; Kazuo Chin, MD, PhD2
1Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan; 2Departments of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan; 3Department of Rehabilitation, Kyoto University Hospital, Kyoto, Japan; 4Departments of Allergy and Rheumatology, Tokyo University Graduate School of Medicine, Tokyo, Japan
There are no clinical data comparing adherence and quality of life between auto-adjusting positive airway pressure (APAP) and two different flex positive airway pressure (PAP) devices (A-Flex, C-Flex) in patients with obstructive sleep apnea (OSA).
Design and Setting:
Ninety-three patients in whom OSA was newly diagnosed were randomly assigned to receive 3 mo of APAP (n = 31), APAP with C-Flex (n = 31), or APAP with A-Flex (n = 31). Objective adherence was determined after 3 mo of CPAP treatment, and the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Calgary Sleep Apnea Quality of Life Index (SAQLI) were examined at baseline and after 3 mo. After 3 mo, patients in the APAP with A-Flex group and those in the APAP with C-Flex group were crossed over and those in the APAP group were switched to A-Flex for an additional 3 mo.
Measurements and Results:
The groups were similar demographically. Treatment adherence during the first 3 mo was significantly greater in the APAP with C-Flex group (APAP with C-Flex: 5.19 ± 1.84 h/night versus APAP: 3.96 ± 1.66 h/night versus APAP with A-Flex: 4.27 ± 2.12 h/night, P = 0.04). There was a significant improvement in two of four of the SAQLI domain scores and in the ESS and PSQI in the APAP with C-Flex group. Adherence significantly improved among the poor compliers (< 4 h/night of use) in the APAP group after change to APAP with A-Flex (P = 0.01).
Of these three modes of PAP delivery, adherence was greatest with APAP with C-Flex.
Chihara Y; Tsuboi T; Hitomi T; Azuma M; Murase K; Toyama Y; Harada Y; Aihara K; Tanizawa K; Handa T; Yoshimura C; Oga T; Yamamoto K; Mishima M; Chin K. Flexible positive airway pressure improves treatment adherence compared with auto-adjusting PAP. SLEEP 2013;36(2):229-236.