title: Intensive versus standard follow-up to improve continuous positive airway pressure compliance.
abstract: We aimed to compare the effect of intensive versus standard interventions on continuous positive airway pressure (CPAP) adherence 2 years after CPAP initiation, as well as on sleepiness, quality of life, depression, hospitalisation and death rate due to cardiovascular disease (CVD). 3100 patients with newly diagnosed sleep apnoea were randomised into the standard group, with usual follow-up care, or the intensive group, with additional visits, telephone calls and education. Subjective daytime sleepiness (Epworth Sleepiness Scale; ESS), quality of life (36-item Short Form Health Survey; SF-36) and the patient's level of depression (Beck Depression Inventory; BDI) were recorded before and 2 years after CPAP initiation, together with CVD hospitalisations and death rate. 2 years after CPAP initiation, the intensive group used CPAP significantly more than the standard group (6.9 versus 5.2 h per night; p<0.001). ESS, SF-36 and BDI scores were also significantly better in the intensive group. Furthermore, the standard group had significantly more deaths and hospitalisations due to CVD. CPAP usage can be improved by both intensive and standard patient support. However, the patients who received intensive CPAP support had significantly better ESS, BDI and SF-36 scores, and lower cardiovascular morbidity and mortality, suggesting that an intensive programme could be worthwhile.
authors.affiliation: Sleep Disorders Center, Dept of Thoracic Medicine, University of Crete, Heraklion, Crete, Greece izolthi@gmail.com.
authors.forename: Izolde
authors.initials: I
authors.lastname: Bouloukaki
authors.affiliation: Sleep Disorders Center, Dept of Thoracic Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Giannadaki
authors.affiliation: Sleep Disorders Center, Dept of Thoracic Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Mermigkis
authors.affiliation: Sleep Disorders Center, Dept of Thoracic Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tzanakis
authors.affiliation: Sleep Disorders Center, Dept of Thoracic Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Mauroudi
authors.affiliation: Sleep Disorders Center, Dept of Thoracic Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Violeta
authors.initials: V
authors.lastname: Moniaki
authors.affiliation: Sleep Disorders Center, Dept of Thoracic Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Stylianos
authors.initials: S
authors.lastname: Michelakis
authors.affiliation: Sleep Disorders Center, Dept of Thoracic Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Nikolaos M
authors.initials: NM
authors.lastname: Siafakas
authors.affiliation: Sleep Disorders Center, Dept of Thoracic Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Sophia E
authors.initials: SE
authors.lastname: Schiza
mesh_terms: D000328:Adult; D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000191:economics / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017286:Polysomnography; D011446:Prospective Studies; D011788:Quality of Life; D020181:Sleep Apnea, Obstructive / Q000191:economics / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires