title: [Analysis of long-term compliance to continuous positive airway pressure in patients with obstructive sleep apnea].
abstract: OBJECTIVE
  To explore the continuous positive airway pressure (CPAP) therapy compliance in patients with obstructive sleep apnea (OSA).
  
  
  METHODS
  This prospective study recruited a group of subjects from May 2009 to December 2013 who were diagnosed and had accepted CPAP treatment in Sleep Center of Guangdong General Hospital, and the patients were followed-up regularly for long-term and assessed the CPAP treatment compliance. The patients were diagnosed, had pressure titration and CPAP treatment through out of center sleep test. The subjects were followed-up for 1 st, 3rd, 6th, 12th month, and each year regularly after accepting the CPAP treatment in Sleep Center by face to face follow-up with specialist physicians. Physicians followed-up the patients' subjective symptoms, CPAP adherence, patient education and side effect solutions. The patients were classified into good and poor compliance groups, and statistical analysis was done between the two groups.
  
  
  RESULTS
  There were 77 cases enrolled until December 2015, only 73 patients completed the study. The patients were followed-up about 2-6 years, the average was (3.93±1.29) years, the compliance accounted for 54.8% (40/73), and the average compliance was (4.02±1.87) hours/night. The trend of the long-term compliance showed that there was a gradual increase within the first 3 months of CPAP treatment and then the compliance decreased; it then increased gradually after the first two years. The good compliance group showed that the compliance increased gradually in the initial 3 months, and then fell; from the first year to the 3rd year, the compliance was stable; after the 3rd year there was a drop and the compliance tended to increase again after the 4th year. The poor compliance group showed the compliance had a downward trend from the beginning of the first two years, then after a brief rise, the compliance decreased linearly. Multivariate analysis showed that long-term compliance was not associated with age, daytime sleepiness (ESS), oxygen desaturation index (ODI), anxiety, depression (P>0.05), etc. However, it was associated with the time of the titration treatment (P<0.001), the time of the flow monitored (P<0.01) and the number of the pressure titration within one week (P<0.05).
  
  
  CONCLUSIONS
  Long-term compliance shows a curve change, the increased compliance is related with the regular follow-up. Long-term compliance can be predicted by the degree of cooperation with the initial diagnosis and treatment.
authors.affiliation: Division of Respiratory Diseases, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Institute of Geriatrics (Wang Qian Is Studying in Clinical Medicine, Shantou University Medical College), Guangzhou 510080, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Wang
authors.forename: Q
authors.initials: Q
authors.lastname: Ou
authors.forename: X T
authors.initials: XT
authors.lastname: Tian
authors.forename: Y C
authors.initials: YC
authors.lastname: Chen
authors.forename: Z Q
authors.initials: ZQ
authors.lastname: Nie
authors.forename: X L
authors.initials: XL
authors.lastname: Gao
mesh_terms: D045422:Continuous Positive Airway Pressure; D005500:Follow-Up Studies; D006801:Humans; D010349:Patient Compliance; D017286:Polysomnography; D011446:Prospective Studies; D012890:Sleep; D020181:Sleep Apnea, Obstructive; D013995:Time