Am. J. Respir. Crit. Care Med., Volume 160, Number 4, October 1999, 1124-1129

Effective Compliance during the First 3 Months of Continuous Positive Airway Pressure
A European Prospective Study of 121 Patients

JEAN LOUIS PÉPIN, JEAN KRIEGER, DANIEL RODENSTEIN, ANDRÉ CORNETTE, EMILIA SFORZA, PIERRE DELGUSTE, CHRYSTÈLE DESCHAUX, VÉRONIQUE GRILLIER, and PATRICK LÉVY

Department of Respiratory Medicine and Sleep Laboratory, University Hospital, Grenoble, France; Sleep Disorders Unit, University Hospital, Strasbourg, France; Respiratory Department, University Hospital of Nancy, Vandoeuvre-les-Nancy, France; Respiratory Department, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium; Nellcor Puritan Bennett FD, Nancy-les-Villers, France; and PRETA Laboratory, UMR CNRS 5525, Department of Physiology, Faculty of Medicine, Joseph Fourier University, Grenoble, France

Effective compliance (time spent at the effective pressure) with nasal CPAP in obstructive sleep apnea has been reported to be poor. The aim of our study was to evaluate effective compliance in a large European multicenter study. One hundred twenty-one consecutive newly treated patients (initial apnea-hypopnea index [AHI] = 62.0 ± 29.5/h, AHI under CPAP = 6.4 ± 8.1/h, CPAP pressure = 8.7 ± 2.6 cm H₂O, BMI = 33.1 ± 6.8 kg/m²) were randomly allocated to a group with (MC⁺) (n = 58) or without (MC) (n = 63) a control unit measuring effective compliance at 1, 2, and 3 mo, which was compared with the built-in time counter data. MC⁺ data were 94 ± 10, 98 ± 5, and 96 ± 9% of counter data at 1, 2, and 3 mo, respectively. Using criteria of regular use already reported in the literature (at least 4 h of nCPAP per day of use and nCPAP administered more than 70% of the days) we found 77, 82, and 79% compliant patients at 1, 2, and 3 mo, respectively, 79% of the patients meeting these criteria each month. Although there were no pulmonary functions or polysomnographic differences between the two subgroups, the compliant patients did report a greater improvement in minor symptoms. We found a close correlation between effective use of CPAP and the machine run time. The main result of our study was a higher effective compliance than previously reported, approximately 80% of the patients being regular users versus 46% in a previously published study. This may result from different technical and medical follow-up.

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