Adherence to continuous positive airway pressure in women with obstructive sleep apnoea

Background: Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea (OSA), but compliance and variables involved in CPAP adherence in women are unknown. Objectives: To analyse CPAP adherence and variables associated with CPAP compliance in women with OSA. Methods: We analysed 151 women with moderate-to-severe OSA (AHI≥15) who participated in a randomized controlled trial (NCT02047071) and received CPAP for 3 months. Good adherence was defined as an objective average use ≥ 4 hours/night. To identify independents predictors of adherence, multivariate logistic regression analyses were performed. Results: Nine women were excluded from the analyses because they did not begin CPAP, two women dropped out, and 140 were still on CPAP therapy at the end of the follow-up. The mean CPAP use was 5.09±2.05 hours/night at the end of the first month and 5.24±1.99 hours/night at the end of the follow-up. 73.9% (105/142) of the women had good CPAP adherence at the end of the first month, and 79.6% (113/142) at the end of follow-up. Independent baseline predictors of good adherence were the number of hour of sleep (OR 1.34, 95%CI: 1.01 to 1.76, p=0.038) and the use of antidepressant drugs (OR 0.27, 95%CI: 0.11 to 0.67, p=0.005). In addition, a fewer number of side-effects during the follow-up period was also a predictor of good CPAP adherence (1.8±1.4vs 2.6±1.7, p=0.010). Conclusions: In women with moderate-severe OSA, CPAP adherence at 3 months was adequate. Longer sleep duration predicted better adherence , whereas antidepressant therapy and greater number of side -effects were associated with poorer CPAP adherence.