SCIENTIFIC-PRACTICAL JOURNAL

| укр | рус |

 

 


No3-4(5) 2022

Back to the issue


DOI 10.37219/2528-8253-2022-3-44

Dieieva YV
Low patient compliance to CPAP therapy as a new challenge in the management of patients with obstructive sleep apnea syndrome: social, demographic characteristics and the quality of life
Dieeva Julia V.
MD, PhD, professor
Head of the department of Otorhinolaryngology
Bogomolets National Medical University, Kiev
E-mail: deyeva@bigmir.net
ORCID ID: 0000-0003-0552-1254
https://www.scopus.com/authid/detail.uri?authorId=55359076200

Abstract

Introduction: Obstructive sleep apnea syndrome (OSAS) is one of the most common sleep disorders. According to various studies, the prevalence of OSAS varies between 2-4% of men and 1-2% of women in the general population, with more than 90% of cases among men and 80% of women being undiagnosed. The "gold standard" for the treatment of OSAS is respiratory therapy using CPAP. At the same time, the results of patients' compliance to CPAP are controversial. Thus, the inability to use this method was noted by 45 to 80% of patients, therefore it is important to study this group of patients, who showed low compliance with CPAP.
Aim: to determine the social and demographic characteristics of the group of patients with OSAS and low compliance with CPAP therapy, as well as the impact of the disease on the quality of life of patients.
Materials and methods: The study included 80 patients with second stage OSAS who had previously demonstrated low compliance with CPAP. Overall demographic indicators were assessed, and patients were interviewed to assess their quality of life using The Assessment of Quality of Life (AQoL) instrument. Statist ical criteria included methods of descriptive statistics (mean, mode, median, minimum and maximum value, variance). In case of normal data distribution methods of parametric statistics were used, and in case of uneven distribution – non-parametric criteria.
Results: The gender distribution in the group showed 67.5% of men and 32.5% of women. Average age was 39.35 (±9.49) years and 39.56 (±11.89) years, respectively. The average value of the biomass index in men was 28.3 (±2.9), in women – 28.1 (±3.9). Only three people in the group reached retirement age. The results of the survey of the quality of life showed a significant reduction in the level of "Relationships with others", "Social isolation", "Sleep" and "Anxiety and depression" (p <0.05).
Conclusions: The results of the study showed that the demographic characteristics of the group of patients with OSAS with low compliance to CPAP do not differ from the general patterns.
In addition, a questionnaire using The Assessment of Quality of Life (AQoL) instrument showed a significant decrease in the quality of life of patients due to worsening of social isolation and reduced psychological wellbeing.

Keywords

obstructive sleep apnea syndrome, CPAP, compliance, quality of life.


Reference

  1. Virk JS, Kotecha B. Otorhinolaryngological aspects of sleep-related breathing disorders. J Thorac Dis. 2016;8:213-23. doi: 10.3978/j.issn.2072-1439.2016.01.39.
  2. Young T, Evans L, Finn L, Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep 1997;20:705-6. doi: 10.1093/sleep/20.9.705.
  3. Stradling JR, Crosby JH. Predictors and prevalence of obstructive sleep apnoea and snoring in 1001 middle aged men. Thorax 1991;46:85-90. doi: 10.1136/thx.46.2.85.
  4. He J, Kryger MH, Zorick FJ, et al. Mortality and apnea index in obstructive sleep apnea. Experience in 385 male patients. Chest. 1988;94:9-14.
  5. Guilleminault C, Connolly SJ, Winkle RA. Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. Am J Cardiol 1983;52:490-4. doi: 10.1016/0002-9149(83)90013-9.
  6. George CF, Smiley A. Sleep apnea & automobile crashes. Sleep 1999;22:790-5.
  7. National Institute for Health and Clinical Excellence. Continuous positive airway pressure for obstructive sleep apnoea/hypopnoea syndrome. Available online: https://www.nice.org.uk/guidance/ta139/resources/continuous-posit iveairway-pressure-for-obstructive-sleepapnoeahypopnoea-syndrome-374791501
  8. Monasterio C, Vidal S, Duran J, Ferrer M, Carmona C, Barbй F, et al. Effectiveness of continuous positive airway pressure in mild sleep apneahypopnea syndrome. Am J Respir Crit Care Med. 2001;164:939-43. doi: 10.1164/ajrccm.164.6.2008010.
  9. Bratton DJ, Stradling JR, Barbй F, Kohler M. Effect of CPAP on blood pressure in patients with minimally symptomatic obstructive sleep apnoea: a meta-analysis using individual patient data from four randomised controlled trials. Thorax, 2014: 69(12): 1128-35. doi: 10.1136/thoraxjnl-2013-204993.
  10. Donovan LM, Boeder S, Malhotra A, Patel SR. New developments in the use of positive airway pressure for obstructive sleep apnea. J. Thorac. Dis. 2015:7(8):1323. doi: 10.3978/j.issn.2072-1439.2015.07.30.
  11. Lindberg E, Berne C, Elmasry A, Hedner J, Janson C. CPAP treatment of a population-based sample – what are the benefits and the treatment compliance? Sleep Med. 2006;7:553-60. doi: 10.1016/ j.sleep.2005.12.010.
  12. Denysenko R, Dikhtiaruk O, Naumenko O. [Influence of modified uvulopalatopharyngoplasty on body weight and quality of night sleep in patients with low compliance to CPAP therapy]. Otorhinolaryngology. 2020:3(4):73-8. doi 10.37219/2528-8253-2020-4-73. [Article in Ukrainian].
  13. Boudewyns A, Marklund M, Hochban W. Alternatives for OSAHS treatment: selection of patients for upper airway surgery and oral appliances. Eur Respir J. 2007:16(106):132-145. doi: 10.1183/ 09059180.00010604
  14. Hawthorne G, Richardson J, Osborne R. The Assessment of Quality of Life (AQoL) instrument: a psychometric measure of health-related quality of life. Qual Life Res. 1999:8(3):209-24. doi: 10.1023/a:1008815005736.
  15. Garvey JF, Pengo MF, Drakatos P, Kent BD. Epidemiological aspects of obstructive sleep apnea. J. Thorac. Dis. 2015:7(5): 920. doi: 10.3978/j.issn.2072-1439.2015.04.52.
  16. Dutt N, Janmeja AK, Mohapatra PR, Singh AK. Quality of life impairment in patients of obstructive sleep apnea and its relation with the severity of disease. Lung India: Official Organ of Indian Chest Society. 2013:30(4):289. doi: 10.4103/0970-2113.120603.
  17. Guyatt G. Insights and limitat ions from healthrelated quality-of-life research. J Gen Intern Med. 1997:12(11):720-1. doi: 10.1046/j.1525-1497.1997.07149.x.
 

© 2019, Public Organization «Ukrainian Scientific Medical Society of Otorhinolaryngologists»