Self-Reported Use of CPAP and Benefits of CPAP Therapy: A Patient Survey

doi:10.1378/chest.109.6.1470

Chest

Volume 109, Issue 6, June 1996, Pages 1470-1476

https://doi.org/10.1378/chest.109.6.1470 Get rights and content

The benefits of continuous positive airway pressure (CPAP) therapy in patients with the sleep apnea/hypopnea syndrome (SAHS) are poorly documented and patients use CPAP less than physicians recommend. To establish patients' perceptions of benefit from CPAP and to identify determinants of CPAP use, 204 CPAP users completed a questionnaire relating to use of CPAP therapy, sleepiness, and road traffic incident rate before and after CPAP, perceived change in daytime function and nocturnal symptoms with treatment, and problems with CPAP. Variables from these domains of interest were examined, reduced through principal components analysis and correlated to assess associations between these and polysomnographic measures of illness severity. Self-reported CPAP use averaged 5.8±SD 2 h a night. Subjective sleepiness rated by the Epworth sleepiness scale and road traffic incident rate were significantly reduced by CPAP (p<0.0001). A broad range of function and symptom items were highly significantly improved with CPAP (p<0.0001), corroborating the cost to community and industry from SAHS and the preventive value of CPAP. Road traffic incident rate before treatment was correlated with pre-CPAP sleepiness and SAHS severity. Subjective CPAP use correlated with sleepiness before treatment but not with SAHS severity. CPAP mask problems and side effects were not associated with reduced CPAP use, but “nuisance” complaints of awakenings, noise, and sore eyes from CPAP correlated negatively with reported use. Greater reported CPAP use was associated with better resolution of sleepiness and greater improvement in daytime function and nocturnal symptoms.

Section snippets

Study Design

A questionnaire was sent in June 1994 to all patients issued CPAP units by the Scottish National Sleep Laboratory (SNSL) for 2 weeks or longer. Questionnaire data were supplemented with information, obtained from SNSL records, on age, sex, polysomnographic SAHS severity, objective CPAP use from run-time clock readings, and objective daytime sleepiness on the multiple sleep latency test (MSLT).²⁸ Posttreatment MSLTs were conducted after at least 4 weeks of receiving CPAP. Information from the

Questionnaire Response

Of 253 patients (26 female) issued CPAP units, 215 (85%) returned questionnaires. Nonresponders were significantly younger (mean [±SD] age, 46±9 years) than responders (53±10 years; p<0.0001), but were otherwise no different from the responders, who had a mean AHI³³ of 47±38 per hour slept, 47±40 microarousals³⁴ per hour slept, average minimum oxygen saturation of 74±18%, and mean duration of CPAP treatment of 632 days (range, 16 to 2,921 days).

Eleven patients (5% of responders) stated that

DISCUSSION

This study documents experience and perceptions of CPAP in a large sample of unselected CPAP users with a wide range of illness severity. Although necessarily limited by its use of mainly self-reported and retrospective information, the study provides evidence of patient-perceived, CPAP-induced improvement across a wide range of function, including sleepiness, driving competence, cognitive function, work efficiency, well-being, and nocturnal symptoms. Furthermore, coherent correlations linked

ACKNOWLEDGMENT

We thank the nursing, technical, and administrative staff of the SNSL for their contributions to this project.

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Citation Excerpt :
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Copies of the survey are available from the authors by contacting Heather Engleman, Scottish National Sleep Laboratory, Scottish Infirmary of Edinburgh, Lauriston Place, Edinburgh EH3 9YW, UK; phone (+44)131 536-2355; fax (+44)131 536-3255

Supported by a grant from the British Lung Foundation (H.M. Engleman).

revision accepted November 29.

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Chest

Clinical Investigations: Sleep and BreathingSelf-Reported Use of CPAP and Benefits of CPAP Therapy: A Patient Survey

Section snippets

Study Design

Questionnaire Response

DISCUSSION

ACKNOWLEDGMENT

Lancet

Chest

Chest

Chest

Chest

Chest

Chest

Chest

Lancet

Chest

Effects of one night without nasal CPAP treatment on sleep and sleepiness in patients with obstructive sleep apnea

Am Rev Respir Dis

Persistent neuropsychological deficits and vigilance impairment in sleep apnea syndrome after treatment with continuous positive airways pressure (CPAP)

J Clin Exp Neuropsychol

Daytime sleepiness, cognitive performance and mood after CPAP therapy for the sleep apnoea hypopnoea syndrome

Thorax

Compliance with CPAP therapy in patients with the sleep apnoea/hypopnoea syndrome

Thorax

Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea

Am Rev Respir Dis

Compliance and side effects in sleep apnea patients treated with nasal continuous positive airway pressure

West J Med

Treatment of obstructive sleep apnea with nasal continuous positive airway pressure: patient compliance, perception of benefits, and side effects

Am Rev Respir Dis

Driving simulator performance in patients with sleep apnea

Am Rev Respir Dis

Clinical Investigations: Sleep and Breathing
Self-Reported Use of CPAP and Benefits of CPAP Therapy: A Patient Survey