Source: Annual Congress 2002 - Aspects of respiratory disease in primary care
Disease area: Sleep and breathing disorders

Abstract

HYPOTHESIS: Comprehensive examination by a sleep medicine specialist will improve patient compliance with nasal CPAP for obstructive sleep apnea (OSA).
BACKGROUND: The pathophysiologic basis of OSA is often multifactorial, complicated by co-morbid conditions, and implementation of CPAP is not intrinsically natural. Compliance is usually determined within the first 3 months of therapy. Therefore, it is preferable that patients undergoing polysomnography with nasal CPAP have a prior comprehensive consultation with a sleep specialist who is familiar with these issues.
METHODS: A retrospective analysis was performed on all patients suspected with OSA who were referred to the sleep center in the year 2001. Patients who were examined by a sleep center specialist (470) were compared to those referred for testing without consultation (240). Compliance was defined as reported use of CPAP >= 4 hours/night and >= 4 nights/week at >= 6 months after prescription. Probabilities were calculated with a t-test (2-tailed, p < 0.05).
RESULTS: Responses were obtained from 53.2% seen in consultation and from 44.6% not seen. Patients seen by the sleep specialists included a greater proportion of less severe OSA but there was otherwise no significant difference in outcome regarding reported compliance.

CONSULTATION	AGE	BMI	EPWORTH SCORE	RDI	CPAP LEVEL	COMPLIANCE
YES	50.3 yr	36.1	12.5	46.8/hr	8.4 cm H2O	66.4%
NO	51.1 yr	34.4	13.4	55.6/hr	9.2 cm H2O	74.8%
PROBABILITY	.43	.15	.12	.001	.0001	.54

CONCLUSIONS: Compliance with nasal CPAP does not seem to be dependent upon prior consultation with a specialist.

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Citations should be made in the following way:
R. J. Farney, J. M. Walker, T. V. Cloward, N. Trease (). Does consultation with a sleep medicine specialist improve patient compliance with nasal continuous positive airway pressure therapy?. Eur Respir J 2002; 20: Suppl. 38, 2988

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