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. 2017 Oct;9(10):3755-3765.
doi: 10.21037/jtd.2017.09.57.

Long-term adherence to continuous positive airway pressure in patients with rapid eye movement-only obstructive sleep apnea: a prospective cohort study

Aljohara S Almeneessier  1 , Yasser Almousa  2 , Omeima Hammad  2 , Awad H Olaish  2 , Eiman T ALAnbay  2 , Ahmed S BaHammam  2
Affiliations

Long-term adherence to continuous positive airway pressure in patients with rapid eye movement-only obstructive sleep apnea: a prospective cohort study

Aljohara S Almeneessier et al. J Thorac Dis. 2017 Oct.

Abstract

Background: Obstructive sleep apnea (OSA) during rapid eye movement (REM) sleep is a special form of OSA that occurs predominantly during REM sleep. No study has assessed the long-term adherence to continuous positive airway pressure (CPAP) among patients with REM-only OSA. To objectively assess the long-term adherence to CPAP therapy among patients with REM-predominant (REM-only) OSA.

Methods: This was a prospective observational cohort study that included consecutive patients who were diagnosed with OSA. Patients were divided into the following two groups: (I) REM-only OSA [an apnea hypopnea index (AHI) of ≥5, with a REM-AHI/NREM-AHI of >2, an NREM-AHI of <15, and a minimum of 15 min of REM-sleep duration], and (II) non-stage specific OSA. Follow-up was performed at 1, 6 and 12 months after the initiation of CPAP-therapy.

Results: The study included 175 patients; 30 met the criteria for REM-only OSA, and the remaining patients constituted the non-stage specific OSA group. The number of hours of CPAP use per day was significantly lower in the REM-only OSA group at 1, 6 and 12 months compared to the non-stage specific OSA group. At 12 months, the number of hours used per day was 3.8±1.8 and 5.1±2.1 hours in the REM-only and non-stage specific OSA groups, respectively (P=0.003). Approximately 80% of the enrolled participants in both groups were still using CPAP at the end of the study; 23.3% of REM-only OSA patients met the criteria for good adherence (>4 hours/day), and 56.7% met the criteria for partial adherence.

Conclusions: CPAP adherence is lower among patients with REM-only OSA compared to patients with non-stage specific OSA.

Keywords: Continuous positive airway pressure (CPAP); adherence; compliance; rapid eye movement (REM)-related obstructive sleep apnea (OSA); sleep apnea.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Study protocol. OSA, obstructive sleep apnea; CPAP, continuous positive airway pressure; PSG, polysomnography; REM, rapid eye movement.
See this image and copyright information in PMC

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