title: Compliance with continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea among privately paying patients- a cross sectional study.
abstract: BACKGROUND
  To evaluate the compliance, benefits and side effects associated with continuous positive airway pressure (CPAP) therapy among Pakistani patients treated for obstructive sleep apnea (OSA) in private sector.
  
  
  METHODS
  Patients diagnosed to have OSA based on overnight study who were recommended for CPAP therapy, between 1998 and 2003, were evaluated by telephonic survey and review of hospital notes. Compliance, benefits and side effects associated with CPAP therapy were assessed.
  
  
  RESULTS
  Out of 135 patients who were prescribed CPAP therapy, 75 could be contacted. Sixty (80%) started using CPAP within one month of diagnosis and 46 (61%) continued to use it long-term (beyond one year). Compliance with CPAP therapy was associated with higher body mass index, higher Epworth sleepiness scale score, history of witnessed apnea, and reduction in daytime sleepiness with CPAP therapy. OSA severity as assessed by apnea-hypopnea index did not affect compliance with CPAP therapy. Use of anti-depressants and CPAP induced sleep disturbances were associated with poor compliance with CPAP therapy.
  
  
  CONCLUSIONS
  Obesity, excessive daytime sleepiness, witnessed apnea and improvement of daytime symptoms following use of CPAP were predictors of improved compliance. Use of antidepressants and CPAP induced sleep disturbances were predictors of poor compliance.
authors.forename: Syed Fayyaz
authors.initials: SF
authors.lastname: Hussain
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, PO Box 3500, Stadium Road, Karachi 74800, Pakistan. Muhammad.irfan@aku.edu.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Irfan
authors.forename: Zeeshan
authors.initials: Z
authors.lastname: Waheed
authors.forename: Naveen
authors.initials: N
authors.lastname: Alam
authors.forename: Saba
authors.initials: S
authors.lastname: Mansoor
authors.forename: Muhammad
authors.initials: M
authors.lastname: Islam
mesh_terms: D000368:Aged; D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure / Q000009:adverse effects / Q000191:economics; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000209:etiology; D005260:Female; D016304:Hospitals, Private; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D010349:Patient Compliance; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000628:therapy*