Continuous Positive Airway Pressure Compliance in Patients with Obstructive Sleep Apnea | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 21 October 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.425779.4206 | ||
| Authors | ||
| Yasmeen Mostafa Ahmed Abdelkareem* 1; Mohammed M N Abozaid2; Niveen Elsayed Zayed2; Waheed M. Shouman2 | ||
| 1M.B.B.CH, Resident of Chest Diseases, Zagazig Chest Hospital, | ||
| 2Professor of Chest Diseases, Faculty of Medicine, Zagazig University | ||
| Abstract | ||
| Background: Obstructive sleep apnea (OSA) is common, yet underdiagnosed disorder associated with substantial morbidity. Continuous positive airway pressure (CPAP) therapy is the standard treatment for moderate to severe OSA; however, adherence remains a critical determinant of therapeutic success. This research aimed to assess compliance with CPAP therapy among patients with OSA to identify clinical, demographic predictors of non-compliance. Methods: This retrospective cohort study included 100 patients with polysomnography-confirmed OSA who were advised CPAP therapy for 6 months at least at the Sleep Unit. Demographic, clinical, and polysomnographic data were collected, along with Epworth Sleepiness Scale (ESS), STOP-BANG, and Mallampati scores. CPAP adherence was assessed by patient/caregiver report and device memory, with compliance defined as ≥4 hours/night on ≥70% of nights. Result: Compliance was achieved in 62% of patients. Female sex (64.5% vs. 36.8%, p=0.007) and hypertension (58.1% vs. 36.8%, p=0.039) were significantly associated with adherence, while cardiac disease (29.7% vs. 11.8%, p=0.035) and prior ICU admission (63.2% vs. 38.7%, p=0.018) were more frequent in non-compliant patients. Non-compliance was independently predicted by hypertension (AOR 223.6), behavioral problems (AOR 9757.9), difficulty awakening (AOR 234.7), complications (AOR 159.8). CPAP significantly improved sleep quality (93.5% vs. 26.3%, p<0.001), daytime symptoms (90.3% vs. 21.1%, p<0.001) in compliant patients. Conclusion: Compliance with CPAP therapy is essential for achieving symptomatic improvement in patients with OSA. Non-compliance was independently linked to hypertension, cardiac disease, behavioral problems, difficulty awakening, higher ESS scores. Targeted education and strategies addressing these risk factors may optimize adherence reduce the long-term burden of OSA. | ||
| Keywords | ||
| Obstructive sleep apnea; CPAP; Compliance; Adherence; Sleep quality | ||
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