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81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

12.05. - 16.05.2010, Wiesbaden

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Effects of nasal continuous positive airway pressure in obstructive sleep apnea with regard to individual compliance

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  • corresponding author presenting/speaker Boris A. Stuck - Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
  • author Sarah Leitzbach - Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
  • author J. Ulrich Sommer - Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
  • author Clemens Heiser - Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
  • author Karl Hörmann - Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
  • author Joachim T. Maurer - Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Wiesbaden, 12.-16.05.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10hno111

doi: 10.3205/10hno111, urn:nbn:de:0183-10hno1110

Published: July 6, 2010

© 2010 Stuck et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: In the evaluation of surgical intervention in obstructive sleep apnea postoperative results are regularly compared to the outcome of conservative treatment, especially of continuous positive airway pressure (CPAP). In this regard, CPAP appears to be superior in terms of the reduction of respiratory events, at least under sleep lab conditions. Nevertheless, the efficacy of CPAP is highly depending on its use, so outcome data should always consider individual compliance. Aim of the study was to assess the efficacy of CPAP under realistic conditions considering individual compliance data.

Methods: Patient with obstructive sleep apnea receiving CPAP were evaluated with regard to the efficacy of nasal ventilation at the time of their ambulatory control visits. The apnea-hypopnea-index (AHI) was assess before the initiation and during nasal ventilation. Individual compliance was calculated based on the time of treatment and the hours of CPAP use according to the built in counter of the treatment device. Based on the compliance data the time with and without CPAP was assessed and the mean AHI under treatment was calculated based on these results.

Results: At present, 31 patients were evaluated. Mean AHI before treatment was 37.8±23.8, being reduced to 5.4±4.9 after nCPAP tritration under sleep lab conditions. In total, the devices were used for 688 days (corresponding to 5162 hours of sleep). The total hours of use were measured with 3395. The adjusted mean AHI under treatment was 16.5. Only 6 out of 31 patients (19%) were treated effectively under these conditions (AHI<5).

Conclusions: CPAP is highly effective under sleep lab conditions. Nevertheless, based on the individual compliance, the efficacy under every day conditions is limited, as patient were left untreated for a significant amount of time. Individual compliance needs to be considered when evaluating treatment with CPAP and comparing its results with alternative treatment options.