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Compliance with continuous positive airway pressure therapy: assessing and improving treatment outcomes
Abstract
Although nasal continuous positive airway pressure (CPAP) is generally effective in correcting sleep-related respiratory disturbance and associated daytime sequelae in obstructive sleep apnea syndrome (OSAS), resistance to and intolerance of CPAP poses a serious limitation to its use. Failure to comply with treatment has been reported to be as high as 25 to 50%, with patients typically abandoning therapy during the first 2 to 4 weeks of treatment. Reasons for discontinuing CPAP therapy have been primarily related to issues of mask discomfort, nasal dryness and congestion, and difficulty adapting to the pressure. Although there has been great variability in the reported rates of CPAP compliance, there have been few systematic studies to evaluate barriers to CPAP compliance or ways to improve compliance. Early identification of CPAP-related tolerance problems or barriers, psychological factors, and the predictive value of pretreatment background variables ( ie, age and gender) may enhance compliance with therapy. An important goal for OSAS management is the development of intervention strategies and educational approaches that minimize side effects and maximize patient compliance. A new classification is presented, along with suggestions and ideas for intervention.
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“However, approximately 25-50% of patients with OSA will either refuse the offer of PAP therapy, or will not tolerate it.11”
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Cites
A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale
Johns, M. W. (1991) · Sleep · doi:10.1093/sleep/14.6.540 · Cited by 17,364
The Occurrence of Sleep-Disordered Breathing among Middle-Aged Adults
Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., & Badr, S. (1993) · New England Journal of Medicine · doi:10.1056/nejm199304293281704 · Cited by 10,183
Nieto, F. J. (2000) · JAMA · doi:10.1001/jama.283.14.1829 · Cited by 3,369
Sullivan, C., Berthon-Jones, M., Issa, F., & Eves, L. (1981) · The Lancet · doi:10.1016/s0140-6736(81)92140-1 · Cited by 2,731
Mortality and Apnea Index in Obstructive Sleep Apnea
He, J., Kryger, M. H., Zorick, F. J., Conway, W. A., & Roth, T. G. (1988) · CHEST Journal · doi:10.1378/chest.94.1.9 · Cited by 1,515
Objective Measurement of Patterns of Nasal CPAP Use by Patients with Obstructive Sleep Apnea
Kribbs, N. B., Pack, A. I., Kline, L. R., Smith, P. L., Schwartz, A. R., Schubert, N. M., Redline, S., Henry, J. N., Getsy, J. E., & Dinges, D. F. (1993) · American Review of Respiratory Disease · doi:10.1164/ajrccm/147.4.887 · Cited by 1,339
Daytime Sleepiness, Snoring, and Obstructive Sleep Apnea
Johns, M. W. (1993) · CHEST Journal · doi:10.1378/chest.103.1.30 · Cited by 1,118
Obstructive sleep apnoea syndrome as a risk factor for hypertension: population study
Lavie, P. (2000) · BMJ · doi:10.1136/bmj.320.7233.479 · Cited by 1,019
Katan, M., & van de Bovenkamp, P. (1987) · The Lancet · doi:10.1016/s0140-6736(87)91641-2 · Cited by 967
Population-Based Study of Sleep-Disordered Breathing as a Risk Factor for Hypertension
Young, T. B. (1997) · Archives of Internal Medicine · doi:10.1001/archinte.1997.00440360178019 · Cited by 967
Long-term Use of CPAP Therapy for Sleep Apnea/Hypopnea Syndrome
McARDLE, N., DEVEREUX, G., HEIDARNEJAD, H., ENGLEMAN, H. M., MACKAY, T. W., & DOUGLAS, N. J. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.159.4.9807111 · Cited by 820
ENGLEMAN, H. M., KINGSHOTT, R. N., WRAITH, P. K., MACKAY, T. W., DEARY, I. J., & DOUGLAS, N. J. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.159.2.9803121 · Cited by 558
Wright, J., Johns, R., Watt, I., Melville, A., & Sheldon, T. (1997) · BMJ · doi:10.1136/bmj.314.7084.851 · Cited by 410
HOY, C. J., VENNELLE, M., KINGSHOTT, R. N., ENGLEMAN, H. M., & DOUGLAS, N. J. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.159.4.9808008 · Cited by 379
Indications for Positive Airway Pressure Treatment of Adult Obstructive Sleep Apnea Patients
Loube, D. I., Gay, P. C., Strohl, K. P., Pack, A. I., White, D. P., & Collop, N. A. (1999) · Chest · doi:10.1378/chest.115.3.863 · Cited by 363
Nasal CPAP: An Objective Evaluation of Patient Compliance
Reeves-Hoché, M. K., Meck, R., & Zwillich, C. W. (1994) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.149.1.8111574 · Cited by 358
Ballester, E., Badia, J. R., Hernández, L., CARRASCO, E., de PABLO, J., FORNAS, C., Rodriguez‐Roisin, R., & Montserrat, J. M. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.159.2.9804061 · Cited by 348
Massie, C. A., Hart, R. W., Peralez, K., & Richards, G. N. (1999) · Chest · doi:10.1378/chest.116.2.403 · Cited by 308
Mouth Leak With Nasal Continuous Positive Airway Pressure Increases Nasal Airway Resistance
Richards, G. N., Cistulli, P. A., Ungar, R. G., Berthon-Jones, M., & Sullivan, C. E. (1996) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.154.1.8680678 · Cited by 279
BaHammam, A. S., Delaive, K., Ronald, J., Manfreda, J., Roos, L. L., & Kryger, M. H. (1999) · SLEEP · doi:10.1093/sleep/22.6.740 · Cited by 276
Pépin, J., Krieger, J., Rodenstein, D. O., Cornette, A., Sforza, E. A., Delguste, P., Deschaux, C., GRILLIER, V., & Levy, P. A. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.160.4.9802027 · Cited by 274
Compliance With Nasal CPAP Can Be Improved by Simple Interventions
Chervin, R. D., Theut, S., Bassetti, C., & Aldrich, M. S. (1997) · Sleep · doi:10.1093/sleep/20.4.284 · Cited by 242
Improvement of Mild Sleep-disordered Breathing with CPAP Compared with Conservative Therapy
REDLINE, S., ADAMS, N., STRAUSS, M. E., ROEBUCK, T., WINTERS, M., & ROSENBERG, C. (1998) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.157.3.9709042 · Cited by 240
Meurice, J.-C., Doré, P., Paquereau, J., Neau, J., Ingrand, P., Chavagnat, J.-J., & Patte, F. (1994) · CHEST Journal · doi:10.1378/chest.105.2.429 · Cited by 238
Long-Term Compliance With CPAP Therapy in Obstructive Sleep Apnea Patients and in Snorers
Krieger, J., Kurtz, D., Petiau, C., Sforza, E. A., & Trautmann, D. (1996) · SLEEP · doi:10.1093/sleep/19.suppl_9.s136 · Cited by 201
Risk of traffic accidents in patients with sleep-disordered breathing: reduction with nasal CPAP
Cassel, W., Ploch, T., Becker, C., Dugnus, D., Peter, J., & von Wichert, P. (1996) · European Respiratory Journal · doi:10.1183/09031936.96.09122606 · Cited by 201
Long-term Acceptance of Continuous Positive Airway Pressure in Obstructive Sleep Apnea
Rolfe, I. E., Olson, L. G., & Saunders, N. A. (1991) · American Review of Respiratory Disease · doi:10.1164/ajrccm/144.5.1130 · Cited by 194
Patient Compliance with Nasal CPAP Therapy for Sleep Apnea
SANDERS, M. H., Gruendl, C. A., & Rogers, R. M. (1986) · CHEST Journal · doi:10.1378/chest.90.3.330 · Cited by 192
Continuous Versus Bilevel Positive Airway Pressure for Obstructive Sleep Apnea
Reeves-Hoché, M. K., Hudgel, D. W., Meck, R., Witteman, R., Ross, A., & Zwillich, C. W. (1995) · American journal of respiratory and critical care medicine · doi:10.1164/ajrccm.151.2.7842204 · Cited by 192
Krieger, J. (1992) · SLEEP · doi:10.1093/sleep/15.suppl_6.s42 · Cited by 184
Engleman, H. M., Cheshire, K., Deary, I. J., & Douglas, N. J. (1993) · Thorax · doi:10.1136/thx.48.9.911 · Cited by 181
Self-Reported vs Measured Compliance with Nasal CPAP for Obstructive Sleep Apnea
Rauscher, H., Formanek, D., Popp, W., & Zwick, H. (1993) · CHEST Journal · doi:10.1378/chest.103.6.1675 · Cited by 177
Pelletier‐Fleury, N., Rakotonanahary, D., & Fleury, B. (2001) · Sleep Medicine · doi:10.1016/s1389-9457(00)00063-0 · Cited by 162
Comparison of nose and face mask CPAP therapy for sleep apnoea
Mortimore, I. L., Whittle, A. T., & Douglas, N. J. (1998) · Thorax · doi:10.1136/thx.53.4.290 · Cited by 149
Nino‐Murcia, G., McCann, C. C., Bliwise, D. L., Guilleminault, C., & Dement, W. C. (1989) · PubMed Central · Cited by 145
Hui, D. S. C., Chan, J. K. W., Choy, D. K. L., Ko, F. W. S., Li, T. S. T., Leung, R. C. C., & Lai, C. K. W. (2000) · Chest · doi:10.1378/chest.117.5.1410 · Cited by 141
Fletcher, E. C., & Luckett, R. A. (1991) · American Review of Respiratory Disease · doi:10.1164/ajrccm/143.5_pt_1.936 · Cited by 133
JANSON, C., NÖGES, E., SVEDBERG-BRANDT, S., & LINDBERG, E. (2000) · Respiratory Medicine · doi:10.1053/rmed.1999.0703 · Cited by 121
Hudgel, D. W., & Fung, C. (2000) · Sleep · doi:10.1093/sleep/23.5.1g · Cited by 112
Constant vs Automatic Continuous Positive Airway Pressure Therapy
d'Ortho, M.-P., Grillier-Lanoir, V., Levy, P., Goldenberg, F., Corriger, E., Harf, A., & Lofaso, F. (2000) · Chest · doi:10.1378/chest.118.4.1010 · Cited by 103
KONERMANN, M., Sanner, B. M., Vyleta, M. S., Laschewski, F., Groetz, J., Sturm, A., & Zidek, W. (1998) · CHEST Journal · doi:10.1378/chest.113.3.714 · Cited by 97
Grunstein, R. R. (1995) · Thorax · doi:10.1136/thx.50.10.1106 · Cited by 95
CPAP therapy in patients with mild OSA: implementation and treatment outcome
Rosenthal, L. D., Gerhardstein, R. R., Lumley, A., Guido, P. S., Day, R. C., Syron, M. L., & Roth, T. G. (2000) · Sleep Medicine · doi:10.1016/s1389-9457(00)00012-5 · Cited by 93
Nasal-CPAP, Surgery, and Conservative Management for Treatment of Obstructive Sleep Apnea Syndrome
Lojander, J., Maasilta, P. K., Partinen, M., Brander, P. E., Salmi, T. K., & Lehtonen, H. (1996) · CHEST Journal · doi:10.1378/chest.110.1.114 · Cited by 93
Sforza, E., & Lugaresi, E. (1995) · SLEEP · doi:10.1093/sleep/18.3.195 · Cited by 83
Management of obstructive sleep apnea: Comparison of various treatment modalities
Katsantonis, G. P., Branham, G. H., Chambers, G., Schweitzer, P. K., & Walsh, J. K. (1988) · The Laryngoscope · doi:10.1288/00005537-198803000-00013 · Cited by 79
Nasal Continuous Positive Airway Pressure Treatment: Current Realities and Future
Berthon-Jones, M., Lawrence, S., Sullivan, C. E., & Grunstein, R. R. (1996) · SLEEP · doi:10.1093/sleep/19.suppl_9.s131 · Cited by 74
Strollo, P. J., SANDERS, M. H., & Atwood, C. W. (1998) · Clinics in Chest Medicine · doi:10.1016/s0272-5231(05)70431-7 · Cited by 60
Compliance with CPAP in elderly patients with OSA
Parish, J. M., Lyng, P. J., & Wisbey, J. A. (2000) · Sleep Medicine · doi:10.1016/s1389-9457(00)00011-3 · Cited by 36
Objective patient compliance in long-term use of nCPAP
Fleury, B., Rakotonanahary, D., Hausser‐Hauw, C., Lebeau, B., & Guilleminault, C. (1996) · European Respiratory Journal · doi:10.1183/09031936.96.09112356 · Cited by 30
Ball, E. M., & Banks, M. B. (2001) · Sleep Medicine · doi:10.1016/s1389-9457(01)00086-7 · Cited by 20
Evaluation of Treatment Efficacy in Sleep Apnea Hypopnea Syndrome
Sériès, F. (1996) · SLEEP · doi:10.1093/sleep/19.suppl_9.s71 · Cited by 11
Research works printed but not linked: 10
- Young, 1997, Arch Intern Med, 157, 1746, 10.1001/archinte.157.15.1746 · DOI
- Strobel, 1997, Am J Respir Crit Care Med, 155, A133
- Kline, 1999, Sleep, 22, S230
- Grunstein, 1996, Sleep Res, 25, 211
- Sforza, 1995, Sleep, 18, 195
- Stepnowsky, 2000, Sleep, 23, A287
- Zozula, 2001, Sleep, 24, A9
- Nino-Murcia, 1989, West J Med, 150, 165
- Issa, 1985, Am Rev Respir Dis, 131, A108
- Speer, 1997, Sleep Res, 26, 216
Cited by
Sorted by citations
Wozniak, D. R., Lasserson, T. J., & Smith, I. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007736.pub2 · Cited by 388
International Consensus Statement on Obstructive Sleep Apnea
Chang, J. L., Goldberg, A. N., Alt, J. A., Mohammed, A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., et al. (2023) · International Forum of Allergy & Rhinology · doi:10.1002/alr.23079 · Cited by 350
Practice Parameters for the Medical Therapy of Obstructive Sleep Apnea
Standards of Practice Committee of the American Academy of Sleep Medicine, Morgenthaler, T. I., Kapen, S., Lee-Chiong, T., Alessi, C., Boehlecke, B., Brown, T., Coleman, J., Friedman, L., Kapur, V., et al. (2006) · Sleep · doi:10.1093/sleep/29.8.1031 · Cited by 299
Early Predictors of CPAP Use for the Treatment of Obstructive Sleep Apnea
Lewis, K. E., Seale, L., Bartle, I. E., Watkins, A. J., & Ebden, P. (2004) · Sleep · doi:10.1093/sleep/27.1.134 · Cited by 242
Veasey, S. C., Guilleminault, C., Strohl, K. P., Sanders, M. H., Ballard, R. D., & Magalang, U. J. (2006) · SLEEP · doi:10.1093/sleep/29.8.1036 · Cited by 217
Metadata
- Authors
- Zozula, R., & Rosen, R.
- Affiliations
- Robert Wood Johnson University Hospital (US)
- Corresponding author
- Zozula, Rochelle
- Venue
- Current Opinion in Pulmonary Medicine
- Published
- 2001-11
- Volume
- 7
- Issue
- 6
- Pages
- 391-398
- ISSN
- 1070-5287 (ISSN-L)
- OpenAlex
- W2328579826
- Cited by
- 189
- References
- 52
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 5 · 2022: 8 · 2021: 9 · 2020: 12 · 2019: 5 · 2018: 7 · 2017: 7 · 2016: 5 · 2015: 8 · 2014: 11 · 2013: 2 · 2012: 8
- FWCI
- 0.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Pulmonary Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k07hl003635-02)
- National Heart, Lung, and Blood Institute (K07 HL 03635)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- CPAP adherence, continuous positive airway pressure, obstructive sleep apnea, CPAP intolerance, mask discomfort, nasal dryness, patient education, barriers to treatment, medication adherence, psychological factors
- MeSH terms
- Humans, Patient Compliance, Patient Education as Topic, Positive-Pressure Respiration, Sleep Apnea Syndromes, Treatment Refusal, Treatment Outcome
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