title: Factors predicting CPAP adherence in obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) is associated with a range of neurocognitive and cardiovascular complications, leading to a compromised quality of life. Continuous positive airway pressure (CPAP) is the gold standard therapeutic intervention for this disorder, yet patient compliance remains essential to its success. This study aimed at identifying the determinants of short-term and long-term CPAP adherence in a group of Lebanese patients.
  
  
  METHODS
  This cross-sectional study, conducted at the Sleep Center of Hôtel-Dieu de France hospital in Lebanon, included patients diagnosed with OSA and treated with CPAP for at least one night between June 2008 and January 2015. Adherence was assessed based on patients' self-report.
  
  
  RESULTS
  The study enrolled 138 patients. Adherence rate was 70.3 % at 6 months and around 50 % after 5 years. Cox models showed that use of nasal masks (HR 0.48, p = 0.048) and higher oxygen desaturation index at baseline (HR 0.98 p = 0.048) were associated with a better short-term CPAP adherence. Patients who bought their devices (HR 0.18, p < 0.001), those who were frequently contacted by the CPAP provider (HR 0.85, p 0.024), and those who reported improvement on treatment (HR 0.36, p < 0.001) were significantly more likely to remain adherent on the long term. Conversely, individuals on a diet plan tended to interrupt the treatment earlier (HR 4.85, p 0.039).
  
  
  CONCLUSIONS
  The present findings should be further explored in order to tailor interventions to the specific needs of different patient profiles and secure an improved CPAP adherence.
authors.affiliation: Pulmonary and Critical Care Department, Hôtel-Dieu de France Hospital, Beirut, Lebanon. riachy@dm.net.lb.
authors.forename: Moussa
authors.initials: M
authors.lastname: Riachy
authors.affiliation: Pulmonary and Critical Care Department, Hôtel-Dieu de France Hospital, Beirut, Lebanon.
authors.forename: Samer
authors.initials: S
authors.lastname: Najem
authors.affiliation: Pulmonary and Critical Care Department, Hôtel-Dieu de France Hospital, Beirut, Lebanon.
authors.forename: Mirella
authors.initials: M
authors.lastname: Iskandar
authors.affiliation: Pulmonary and Critical Care Department, Hôtel-Dieu de France Hospital, Beirut, Lebanon.
authors.forename: Jad
authors.initials: J
authors.lastname: Choucair
authors.affiliation: Pulmonary and Critical Care Department, Hôtel-Dieu de France Hospital, Beirut, Lebanon.
authors.forename: Ihab
authors.initials: I
authors.lastname: Ibrahim
authors.affiliation: Pulmonary and Critical Care Department, Saint Georges Hospital, Beirut, Lebanon.
authors.forename: Georges
authors.initials: G
authors.lastname: Juvelikian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D045422:Continuous Positive Airway Pressure / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Adherence; Continuous positive airway pressure; Lebanon; Obstructive sleep apnea