Insomnia symptoms influence CPAP compliance

Sleep Breath. 2013 Mar;17(1):99-104. doi: 10.1007/s11325-012-0655-9. Epub 2012 Feb 4.

Abstract

Purpose: The aim of this study is to determine parameters which influence 6-month compliance of continuous positive airway pressure therapy (CPAP) in patients with obstructive sleep apnea syndrome (OSAS).

Methods: This prospective study investigated 73 patients (24 females) with OSAS and medical indication for CPAP therapy: age 55.1 ± 11.5 years, body mass index (BMI) 30.8 ± 5.0 kg/m2, Apnea-Hypopnea Index (AHI) 39.2 ± 26.7/h, Oxygen Desaturation Index (ODI) 33.2 ± 25.4/h, minimum O(2) saturation 78.9 ± 7.6%. The influence of baseline parameters (demographic and polysomnographic data, sleeping medication intakes, BMI, psychometrics [Epworth Sleepiness Scale, Regensburg Insomnia Scale, Vigilance test and Beck Depression Inventory]) on 6-month compliance was evaluated with a correlation and a linear regression analysis.

Results: The baseline value of the Regensburg Insomnia Scale (RIS) predicts 6-month CPAP compliance (r = -0.376, R (2) = 0.14, p < 0.001), although no other baseline parameter correlates. Patients with a compliance of <4 h/night show higher RIS scores, i.e., more insomnia symptoms (17.6 ± 8.8) compared to those with ≥4 h/night (12.6 ± 6.9; p < 0.05).

Conclusions: Insomnia symptoms prior to the beginning of CPAP treatment show a negative influence on CPAP compliance. Further studies should clarify, if a treatment of insomnia symptoms leads to a benefit in compliance.

MeSH terms

  • Adult
  • Continuous Positive Airway Pressure / psychology*
  • Continuous Positive Airway Pressure / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Germany
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / psychology*
  • Prospective Studies
  • Sleep Apnea, Obstructive / epidemiology
  • Sleep Apnea, Obstructive / psychology*
  • Sleep Apnea, Obstructive / therapy*
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / psychology*
  • Statistics as Topic
  • Utilization Review