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. 2023 Sep 27;24(1):234.
doi: 10.1186/s12931-023-02543-x.

A biphasic effect of age on CPAP adherence: a cross-sectional study of 26,343 patients

Arnaud Prigent  1   2 , Clément Blanloeil  3 , Anne-Laure Serandour  4 , Franck Barlet  5 , Frédéric Gagnadoux  6   7 , Dany Jaffuel  8   9
Affiliations

A biphasic effect of age on CPAP adherence: a cross-sectional study of 26,343 patients

Arnaud Prigent et al. Respir Res. .

Abstract

Background: As the prevalence of OSA increases in older patients, the proportion of elderly patients treated with CPAP is expected to become even higher. We studied CPAP-adherence in a real-life cohort involving a large population of elderly patients with OSA.

Methods: eQUALISAS is a cross-sectional study of CPAP treated OSA patients for at least 4 months who received remote monitoring during 2021. CPAP adherence, device-reported residual AHI (AHICPAP) and 95th percentile non-intentional leaks were software collected during January 2021. Age and sex were also collected.

Results: Data from 26,343 patients including 1656 patients aged [80-85] years and 639 patients aged ≥ 85 years were analysed. Median CPAP adherence increases from 6.3 h (< 50 years) to 7 h (75-80 years) and decreases after this age (p < 0.001). The decrease in CPAP adherence observed after the age of 80 was associated with an increase in the proportion of patients with a CPAP-adherence < 4 h/day (p < 0.001). Proportion of CPAP treated female, patients having AHICPAP mean ≥ 10 events per hour or 95th percentile non-intentional leaks mean over 24 l/min increase with aging of the population. However, for patients over 80 years old, Chi square test showed no association of adherence with gender, AHICPAP and leaks (p > 0.05).

Conclusion: This study demonstrates that adherence gradually increases with age until 80 years. The proportion of non-adherent patients grows with age after 80 years old. No significative relationship was found between adherence after 80 years old and gender, leaks and AHICPAP.

Trial registration: The study is registered on Health Data Hub platform (No. F20220715144543).

Keywords: AHI; Adherence; CPAP; Elderly people; Leaks.

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Conflict of interest statement

Dr Arnaud Prigent is a consultant for Resmed and reports personal fees from Elia Medical, Vitalaire, Bastide, SOS oxygene, GSK and Isis medical, outside the submitted work. Frédéric Gagnadoux reports personal fees from AIR LIQUIDE SANTE, BOEHRINGER. INGELHEIM, CIDELEC, INSPIRE, PHILIPS RESPIRONICS, RESMED, SEFAM, outside the submitted work; non-financial support from AIR LIQUIDE SANTE, ASTEN SANTE, BOEHRINGER INGELHEIM SEFAM, outside the submitted work. Dr. Dany JAFFUEL reports personal fees from Philips Healthcare, personal fees from Resmed, personal fees and non-financial support from SEFAM, personal fees from Lowenstein, personal fees from NOMICS, personal fees from Jazz, personal fees from Bioprojet, outside the submitted work. Dr. Dany Jaffuel, is an Editor of the Respiratory Research journal. Mr Clement BLANLOEIL is an Elia Medical employee. Mr Franck Barlet is CEO of ZOS information system which hosts Elia Medical database. Ms Anne-Laure Serandour has no conflict of interest.

Figures

Fig. 1
Fig. 1
CPAP use (h/day) by age, number of years of use by age. a CPAP use by age. Values expressed as median during January 2021. P < 0.001 (Kruskal–wallis test). Red curve: proportion of non-adherent patients (mean adherence < 4h/day) by age group. b CPAP use by age group and by number of years of use group. *P < 0.05 (Kruskal–Wallis test) significant difference between number of years of use groups. #P < 0.05 (Kruskal–Wallis test) significant difference between age groups
Fig. 2
Fig. 2
CPAP use (h/day) by age, AHICPAP and 95th percentile non-intentional leaks. a CPAP use by age and by gender (female: striped boxes). Values expressed as median during January 2021 (significant difference between age group for male and female P < 0.001 (Kruskal–Wallis test). *p value < 0.05 (Mann-Withney test): significant difference of adherence between female and male for each age group. Red curve: proportion of female by age group. b median CPAP adherence during January 2021 by age by groups of 95th percentile non-intentional leaks over 24 l/min (orange curve), 95th percentile non-intentional leaks under 24 l/min (light orange curve), AHICPAP ≥ 10 events per hour (blue curve:), AHICPAP < 10 events per hour (light blue curve:). *p value < 0.05 (Mann–Withney test): adherence between groups AHI and leaks by age groupe. Proportion of population having monthly mean of 95th percentile non-intentional leaks over 24 l/min (orange dashed line) and monthly mean of AHICPAP ≥ 10 events per hour (blue dashed line) in the general population
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