Introduction Continuous positive airway pressure (CPAP) treatment for Obstructive sleep apnoea (OSA) is associated with variable initial acceptance and subsequent compliance with no consistent association with the severity of symptoms or physiological variables. There are very few data on the role of socioeconomic status, level of education and personality type. A recent retrospective study showed type D personality to be associated with poor compliance.1
Methods All patients with a confirmed diagnosis of OSA, recommended CPAP were considered. Baseline questionnaires were completed to assess employment and socio-economic status and type D personality. Compliance was measured at 6–10 weeks and 6 months.
Results 265 patients participated in the study. Seven switched to Bi-level PA, 2 were excluded and four withdrew their consent; 224 were still using CPAP at 6 months. At baseline mean age was 52.1 (SD 11.0)/y, M:F 205:60 (3.4:1), Epworth sleepiness score (ESS) 14 (SD 4.4), BMI 37.1 (SD 7.8), 4% Desaturation index (DI) 27.9 (SD 20.6)/h and AHI 28.0 (SD 18.6)/h. Mean compliance at 6–10 weeks and 6 months was 5.68 (SD 2.3) h and 5.31 (SD 2.3) h, respectively. 20.5% were using CPAP <4 h/night at 6 weeks and 25.9% at 6 months. In comparison to individuals who were working (or retired from work), those who were long term unemployed (n=17) had a lower average CPAP usage at 6–10 weeks (4.08 h; SD 2.3) and 6 months (3.2 h; SD 2.6). This group was also more likely to use CPAP <4 h/night at 6–10 weeks and 6 months (OR 5.06, p=0.001 and OR 3.62, p=0.01 respectively). No association was found between different Socio-economic classes for people in work, type D personality, education level, sex, age, baseline ESS, DI and AHI with 6–10 weeks or 6 month compliance. Compliance at 6–10 weeks correlated strongly with 6 months compliance (rs=0.82).
Conclusion In our practice there is no significant association between CPAP compliance with socio-economic status, education level or the personality type. People who are long term unemployed may need more intensive support to get optimal benefit from CPAP.