Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/132086
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Predictors of long-term adherence to continuous positive airway pressure in patients with obstructive sleep apnea and cardiovascular disease |
Author: | Van Ryswyk, E. Anderson, C.S. Antic, N.A. Barbe, F. Bittencourt, L. Freed, R. Heeley, E. Liu, Z. Loffler, K.A. Lorenzi-Filho, G. Luo, Y. Margalef, M.J.M. McEvoy, R.D. Mediano, O. Mukherjee, S. Ou, Q. Woodman, R. Zhang, X. Chai-Coetzer, C.L. |
Citation: | Sleep, 2019; 42(10):1-9 |
Publisher: | Oxford University Press |
Issue Date: | 2019 |
ISSN: | 0161-8105 1550-9109 |
Statement of Responsibility: | Emer Van Ryswyk, Craig S. Anderson, Nicholas A. Antic, Ferran Barbe, Lia Bittencourt, Ruth Freed, Emma Heeley, Zhihong Liu, Kelly A. Loffler, Geraldo Lorenzi-Filho, Yuanming Luo, Maria J. Masdeu Margalef, R. Doug McEvoy, Olga Mediano, Sutapa Mukherjee, Qiong Ou, Richard Woodman, Xilong Zhang, and Ching Li Chai-Coetzer, on behalf of the SAVE Investigators and Coordinators |
Abstract: | Study Objectives: Poor adherence to continuous positive airway pressure (CPAP) commonly affects therapeutic response in obstructive sleep apnea (OSA). We aimed to determine predictors of adherence to CPAP among participants of the Sleep Apnea and cardioVascular Endpoints (SAVE) trial. Methods: SAVE was an international, randomized, open trial of CPAP plus usual care versus usual care (UC) alone in participants (45-75 years) with co-occurring moderate-to-severe OSA (≥12 episodes/h of ≥4% oxygen desaturation) and established cardiovascular (CV) disease. Baseline sociodemographic, health and lifestyle factors, OSA symptoms, and 1-month change in daytime sleepiness, as well as CPAP side effects and adherence (during sham screening, titration week, and in the first month), were entered in univariate linear regression analyses to identify predictors of CPAP adherence at 24 months. Variables with p <0.2 were assessed for inclusion in a multivariate linear mixed model with country, age, and sex included a priori and site as a random effect. Results: Significant univariate predictors of adherence at 24 months in 1,121 participants included: early adherence measures, improvement in daytime sleepiness at 1 month, fixed CPAP pressure, some measures of OSA severity, cardiovascular disease history, breathing pauses, and very loud snoring. While observed adherence varied between countries, adherence during sham screening, initial titration, and the first month of treatment retained independent predictive value in the multivariate model along with fixed CPAP pressure and very loud snoring. Conclusions: Early CPAP adherence had the greatest predictive value for identifying those at highest risk of non-adherence to long-term CPAP therapy. |
Keywords: | Sleep apnea; obstructive; continuous positive airway pressure; patient compliance |
Rights: | © Sleep Research Society 2019. Published by Oxford University Press on behalf of the Sleep Research Society. |
DOI: | 10.1093/sleep/zsz152 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1006501 http://purl.org/au-research/grants/nhmrc/1060078 http://purl.org/au-research/grants/nhmrc/343020 |
Published version: | http://dx.doi.org/10.1093/sleep/zsz152 |
Appears in Collections: | Medicine publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.