The gravity of sleep apnea syndrome (SAS), because of the seriousness of diurnal hypersomnia and the cardiorespiratory complications associated with it, made it necessary to develop treatments providing maximum efficacy with minimal side effects. Nocturnal ventilation with nasal continuous positive airway pressure (CPAP) was first proposed by Sullivan et al in 1981, and extensive works confirmed its efficiency in the long-term treatment of SAS.’ Since the work carried out by Sanders et al in 1986 concerning compliance with nasal CPAP various studies have attempted to analyze the compliance of patients with treatment and the factors affecting long-term use of nocturnal ventilation.’ The results are relatively different and do not all apply the same reference criteria. Moreover, there are no precise recommendations available concerning the necessary duration of daily use, and no study has yet focused on the relationship between the evolution of SAS complications and the average number of hours of daily CPAP use. buy asthma inhalers
Likewise, given the long-term nature of the treatment and the constraint it places on patients who are generally young enough to be active both professionally and socially, it is important to determine the factors that could help predict good compliance with nocturnal ventilation using nasal CPAP. This prospective study was performed with the aim of revealing these factors of acceptance, which, in turn, would enable us to improve the long-term effectiveness of such treatment.
Between March 1989 and August 1991, 54 patients suffering from SAS (defined as an apnea/hypopnea index [AHI] greater than 15 per hour of sleep) were included in a prospective study of the long-term acceptance of nocturnal nasal CPAP. Only 44 among the 54 patients were retained because of a consistent use greater than 6 months. The reasons for exclusion were (1) refusal to be treated by CPAP, either immediately (3 patients) or after being treated for a few days (2 patients); (2) failure of CPAP in 2 patients in the course of acute respiratory decompensation related to sleep-induced apnea; (3) definitive clinical improvement after weight loss in a few months in 2 patients; and (4) 1 death, which occurred at the end of 6 months of treatment at home.