title: Factors affecting CPAP acceptance in elderly patients with obstructive sleep apnea in Taiwan.
abstract: BACKGROUND
  The prevalence of obstructive sleep apnea (OSA) increases with age. Treatment often includes CPAP. CPAP adherence is correlated with disease severity and symptoms. We hypothesized that CPAP acceptance rates in elderly patients with OSA would be lower than in younger patients with OSA, and examined factors associated with CPAP acceptance.
  
  
  METHODS
  We reviewed the charts of 315 subjects with OSA (apnea-hypopnea index ≥ 5 events/h) who were treated at our hospital from 2008 to 2011 with CPAP therapy. All underwent CPAP titration testing before CPAP prescription. Subjects were grouped by age: young (25-40 y, n = 35), middle-age (41-65 y, n = 169), and elderly (> 65 y, n = 111). Demographic variables, excessive daytime sleepiness, overnight polysomnography study variables, CPAP acceptance, and CPAP adherence were compared. Regression analysis was performed to identify factors associated with acceptance.
  
  
  RESULTS
  The elderly subjects had less excessive daytime sleepiness and less pronounced alterations in overnight polysomnography variables than the subjects in the other groups, but had more cardiovascular comorbidities. The CPAP acceptance rate (overall 125/315, 39.7%) was significantly lower in the elderly group, compared with the younger group (31.5% vs 60%, P = .01). CPAP acceptance was associated with fewer comorbidities, higher excessive daytime sleepiness, and higher apnea-hypopnea index, but not age. CPAP adherence was not associated with age.
  
  
  CONCLUSIONS
  CPAP acceptance is low in elderly patients in Taiwan. CPAP acceptance, instead of CPAP adherence, is the critical issue with elderly patients with OSA.
authors: Division of Pulmonary and Critical Care Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
authors: Mei-Chen
authors: MC
authors: Yang
authors: Chun-Yao
authors: CY
authors: Lin
authors: Chou-Chin
authors: CC
authors: Lan
authors: Chun-Yao
authors: CY
authors: Huang
authors: Yi-Chih
authors: YC
authors: Huang
authors: Chor-Shen
authors: CS
authors: Lim
authors: Yu-Chih
authors: YC
authors: Liu
authors: Yao-Kuang
authors: YK
authors: Wu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D017286:Polysomnography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012907:Smoking / Q000453:epidemiology; D013624:Taiwan
keywords: CPAP; OSA; acceptance; adherence; elderly; obstructive sleep apnea