Does CPAP Use in the First 15 Days Predict its Use after 4 Months? A Prospective French Cohort Study
|Thibaut Gentina1, Elodie Gentina2*, Catherine Lamblin1, Francois Jouniaux1, Francois Codron1 and Aiman Tulaimat3|
|1Hôpital Privé La Louvière, Générale de Santé, Lille, France|
|2Skema Business School – Université de Lille, MERCUR Research, France|
|3Cook County Health and Hospital Systems, Division of Pulmonary, Critial Care, and Sleep Medicine, France|
|Corresponding Author :||Elodie Gentina
2SKEMA Business School – Université de Lille
MERCUR Research, France
Tel: 00 33(0)6 78 64 47 68
E-mail: elodie. [email protected]
|Received: October 23, 2015 Accepted: December 08, 2015 Published: December 15, 2015|
|Citation: Gentina T, Gentina E, Lamblin C, Jouniaux F, Codron F, et al. (2015) Does CPAP Use in the First 15 Days Predict its Use after 4 Months? A Prospective French Cohort Study. J Sleep Disord Ther 5:222 doi: 10.4172/2167-0277.1000222|
|Copyright: © 2015 Gentina T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Objective: Early prediction of which patients with obstructive sleep apnea will not adhere with CPAP can trigger physicians to correct possible causes or offer alternative therapies. This study aims to determine the ability of early CPAP use to predict long-term adherence with CPAP independent from its definition and to test previously described predictors of adherence.
Method: This is a prospective, observational cohort study that was performed in nine sleep disorder centers in France. Patients were newly diagnosed with obstructive sleep apnea and a CPAP was prescribed for the first time. We collected socioeconomic, medical, sleep, and psychological variables to be associated with adherence with CPAP. The patients were evaluated 15 days after CPAP set up and monthly for 4 months until they were adherent. We assessed potential predictors of CPAP adherence at 4 months with emphasis on CPAP use at 15 days. CPAP adherence was defined as an average daily use of at least 3, 4, 5, and 6 hours.
Results: We enrolled 420 patients. Early CPAP use and CPAP use at 4 months were similar. At 4 months, 94% of patients used a CPAP ≥3 hours and 49% of patients used it ≥6 hours. The area under the ROC curve for early CPAP use predicting adherence at 4 months was ≥0.85 for all adherence definitions. The optimal threshold for early CPAP use to predict adherence increased from 3.2 to 6.4 hours as the definition of CPAP adherence increased from 3 to 6 hours. CPAP use at 4 months was higher in older patients.
Conclusions: Early CPAP use was the single best predictor of CPAP adherence and was independent of how adherence was defined. Physicians must assess CPAP use no later than 2 weeks to address its causes or prescribe an alternative therapy.