title: The importance of clinical monitoring for compliance with Continuous Positive Airway Pressure.
abstract: BACKGROUND
  Obstructive sleep apnea syndrome is currently a public health problem of great importance. When misdiagnosed or improperly treated, it can lead to serious consequences on patients' quality of life. The gold standard treatment for cases of obstructive sleep apnea syndrome, especially in mild to severe and symptomatic cases, is continuous positive airway pressure therapy. Compliance with continuous positive airway pressure therapy is directly dependent on the active participation of the patient, which can be influenced by several factors.
  
  
  OBJECTIVE
  The objective of this study is to describe the factors related to compliance with continuous positive airway pressure therapy, and to analyze which associated factors directly influence the efficiency of the treatment.
  
  
  METHODS
  Patients who received continuous positive airway pressure therapy through the Municipal Health Department of the city of Ribeirão Preto were recruited. A structured questionnaire was administered to the patients. Compliance with continuous positive airway pressure therapy was assessed by average hours of continuous positive airway pressure therapy usage per night. Patients with good compliance (patients using continuous positive airway pressure therapy ≥4h/night) were compared to those with poor compliance (patients using <4h/night).
  
  
  RESULTS
  138 patients were analyzed: 77 (55.8%) were considered compliant while 61 (44.2%) were non-compliant. The comparison between the two groups showed that regular monitoring by a specialist considerably improved compliance with continuous positive airway pressure therapy (odds ratio, OR=2.62).
  
  
  CONCLUSIONS
  Compliance with continuous positive airway pressure therapy is related to educational components, which can be enhanced with continuous and individualized care to patients with obstructive sleep apnea syndrome.
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil.
authors.forename: Lucas B
authors.initials: LB
authors.lastname: Pelosi
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil.
authors.forename: Mariana L C
authors.initials: MLC
authors.lastname: Silveira
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Divisão de Neurologia, Ribeirão Preto, SP, Brazil.
authors.forename: Alan L
authors.initials: AL
authors.lastname: Eckeli
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil; Secretaria Municipal da Saúde de Ribeirão Preto, Ribeirão Preto, SP, Brazil.
authors.forename: Emilia M P C
authors.initials: EMPC
authors.lastname: Chayamiti
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Divisão de Neurologia, Ribeirão Preto, SP, Brazil.
authors.forename: Leila A
authors.initials: LA
authors.lastname: Almeida
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Divisão de Neurologia, Ribeirão Preto, SP, Brazil.
authors.forename: Heidi H
authors.initials: HH
authors.lastname: Sander
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Küpper
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil. Electronic address: facpvalera@uol.com.br.
authors.forename: Fabiana C P
authors.initials: FCP
authors.lastname: Valera
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000628:therapy*
keywords: Adesão; Aparelho de pressão positiva; Apnea; Apneia; Apneia obstrutiva do sono; CPAP; Compliance; OSAS; Obstructive sleep apnea; Positive pressure device; SAOS