[Management of the sleep apnoea syndrome in a general hospital]

Introduction: There are few long-term studies on the management of the sleep apnoea syndrome (SAS).

Patients and methods: We report a retrospective analysis of the management of SAS in the respiratory service of a general hospital between 1st January 1994 and 1st January 2010.

Results: One thousand seven hundred and eighteen patients were diagnosed with SAS and treated with continuous positive airways pressure (CPAP). One thousand one hundred and seventy-three were still being treated on 1st January 2010, representing 68.3% of the total. Four hundred and thirty-three had stopped treatment, representing 25.2% of the total number of patients treated. Four hundred and fourteen patients had died while being treated. The median daily CPAP use among patients still being treated is 6.44 hours. When CPAP was discontinued 45% occurred in the first 6 months and 91% in the first 3 years. The mean apnoea/hypopnoea index of the patients who discontinued treatment was 44 as opposed to 51 for those still using CPAP. The elderly population adhered well to treatment in the long term. The prevalence of severe SAS requiring longer periods of treatment has increased in recent years, probably as the result of practical developments.

Conclusion: The numbers of investigations and of patients starting treatment are increasing constantly. Long-term compliance with CPAP is satisfactory. Discontinuation of treatment occurs mainly in the early months and, above all, in the non-compliant group. SAS is less severe in those patients who discontinue treatment. Old age is not an obstacle to treatment with CPAP.