title: [Continuous positive airway pressure used by adults with obstructive sleep apneas after prescription in a public referral hospital in Mexico City].
abstract: OBJECTIVE
  The aim of this study was to analyze the frequency of initiation of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea syndrome (OSAS) in a referral hospital in Mexico City serving mainly patients without public health insurance coverage and to assess their level of adherence.
  
  
  METHODS
  Patients with OSAS diagnosed by polysomnography or by simplified respiratory polygraphy for whom nasal CPAP was prescribed were enrolled in the study. Titration of CPAP was performed during polysomnography or with an automatic CPAP device. Compliance with treatment was assessed during a medical visit or by telephone interview.
  
  
  RESULTS
  A total of 304 patients were enrolled upon prescription of nasal CPAP; 169 (55.5%) either purchased a device or were provided with one by the social security system. The patients most seriously ill and who had public health insurance coverage were the ones who most often acquired a device. These patients took 1.5 months to obtain the equipment and had a compliance rate of 80% at a mean 34 months of follow-up. The respiratory events index was correlated with compliance, whereas excessive daytime sleepiness (Epworth scale score) and body mass index were predictors of therapeutic CPAP pressure.
  
  
  CONCLUSIONS
  Nearly half the patients who were prescribed CPAP did not acquire the device. Most of those who acquired a device adhered to the treatment. In Mexico access to procedures for diagnosing OSAS is limited and access to treatment is also restricted for patients who do not have public health insurance coverage.
authors.affiliation: Clínica de Trastornos Respiratorios del Dormir, Instituto Nacional de Enfermedades Respiratorias, Secretaría de Salud, México DF, México. luistorreb2001@yahoo.com.mx
authors.forename: Luis
authors.initials: L
authors.lastname: Torre Bouscoulet
authors.forename: Elodia
authors.initials: E
authors.lastname: López Escárcega
authors.forename: Armando
authors.initials: A
authors.lastname: Castorena Maldonado
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Vázquez García
authors.forename: María Sonia
authors.initials: MS
authors.lastname: Meza Vargas
authors.forename: Rogelio
authors.initials: R
authors.lastname: Pérez-Padilla
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure / Q000191:economics / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010349:Patient Compliance / Q000706:statistics & numerical data; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000628:therapy*; D012943:Social Security; D013997:Time Factors; D014505:Urban Population