+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Effect of adherence on daytime sleepiness, fatigue, depression and sleep quality in the obstructive sleep apnea/hypopnea syndrome patients undertaking nasal continuous positive airway pressure therapy



Effect of adherence on daytime sleepiness, fatigue, depression and sleep quality in the obstructive sleep apnea/hypopnea syndrome patients undertaking nasal continuous positive airway pressure therapy



Patient Preference and Adherence 11: 769-779



The aims of this study were to describe changes in day- and nighttime symptoms and the adherence to nasal continuous positive airway pressure (nCPAP) during the first 3-month nCPAP therapy among newly diagnosed patients with obstructive sleep apnea/hypopnea syndrome (OSAS) and to identify the effect of adherence on the changes in day- and nighttime symptoms during the first 3 months. Newly diagnosed OSAS patients were consecutively recruited from March to August 2013. Baseline clinical information and measures of the Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Zung's Self-Rating Depression Scale (SDS) and the Pittsburgh Sleep Quality Index (PSQI) at baseline and the end of 3rd, 6th, 9th and 12th week of therapy were collected. Twelve weeks' adherence was calculated as the average of each 3-week period. Mixed model was used to explore the effect of adherence to nCPAP therapy on ESS, FSS, SDS and PSQI in each 3-week phase. Seventy-six patients completed the 12-week follow-up. The mixed-effects models showed that under the control of therapy phase adherence in the range of <4 hours per night, using nCPAP could independently improve daytime sleepiness, in terms of ESS (coefficient, [95% confidence interval] unit; -4.49 [-5.62, -3.36]). Adherence at 4-6 hours per night could independently improve all variables of day- and nighttime symptoms included in this study, namely ESS -6.69 (-7.40, -5.99), FSS -6.02 (-7.14, -4.91), SDS -2.40 (-2.95, -1.85) and PSQI -0.20 (-0.52, -0.12). Further improvement in symptoms could be achieved at ≥6 hours per night using nCPAP, which was ESS -8.35 (-9.26, -7.44), FSS -10.30 (-11.78, -8.83), SDS -4.42 (-5.15, -3.68) and PSQI -0.40 (-0.82, -0.02). The interaction between adherence level and therapy phase was not significant in day- and nighttime symptoms. The effect of adherence on the above-mentioned symptoms is stable through the first 3 months. Under the control of therapy phase, the nCPAP therapy effectively improves day- and nighttime symptoms with ≥4 hours adherence, and the patients can achieve a further improvement with ≥6 hours adherence.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 059645718

Download citation: RISBibTeXText

PMID: 28442894

DOI: 10.2147/ppa.s128217


Related references

Daytime sleepiness and nasal continuous positive airway pressure therapy in obstructive sleep apnea syndrome patients: Effects of chronic treatment and 1-night therapy withdrawal. Sleep 18(3): 195-201, 1995

Adverse effects and adherence to nasal continuous positive airway pressure in patients with obstructive sleep apnea hypopnea syndrome. Nihon Kokyuki Gakkai Zasshi 42(2): 127-131, 2004

Modafinil for treatment of residual excessive sleepiness in nasal continuous positive airway pressure-treated obstructive sleep apnea/hypopnea syndrome. Sleep 28(4): 464-471, 2005

The influence of excessive daytime sleepiness and sleep quality on anxiety and depression in patients with obstructive sleep apnea hypopnea syndrome. Zhonghua Nei Ke Za Zhi 58(2): 119-124, 2019

Effect of continuous positive airway pressure treatment on the subsequent EEG spectral power and sleepiness over sustained wakefulness in patients with obstructive sleep apnea-hypopnea syndrome. Clinical Neurophysiology 122(5): 958-965, 2011

Subjective sleepiness among patients with obstructive sleep apnea-hypopnea syndrome who were treated with a continuous positive airway pressure device. Sleep and Biological Rhythms 6(3): 155-162, 2008

Difference in continuous positive airway pressure efficiency on excessive daytime sleepiness in sleep apnea/hypopnea syndrome. European Respiratory Journal 8(Suppl. 19): 325S, 1995

Sleepiness, continuous positive airway pressure and the obstructive sleep apnea hypopnea syndrome. Revue des Maladies Respiratoires 35(2): 116-133, 2018

Effects of continuous positive airway pressure on daytime sleepiness in patients with severe obstructive sleep apnea syndrome. Zhonghua Yi Xue Za Zhi 94(6): 412-415, 2014

Findings of the Maintenance of Wakefulness Test and its relationship with response to modafinil therapy for residual excessive daytime sleepiness in obstructive sleep apnea patients adequately treated with nasal continuous positive airway pressure. Sleep Medicine 27-28: 45-48, 2018

Daytime hypercapnia in adult patients with obstructive sleep apnea syndrome in France, before initiating nocturnal nasal continuous positive airway pressure therapy. Chest 127(3): 710-715, 2005

Impact of nasal continuous positive airway pressure on heart rhythm in patients with obstructive sleep apnea/hypopnea syndrome. Minerva Medica 105(3): 255-260, 2014

Nursing Interventions Improve Continuous Positive Airway Pressure Adherence in Obstructive Sleep Apnea With Excessive Daytime Sleepiness: A Systematic Review. Rehabilitation Nursing 2018:, 2018

Efficacy and safety of adjunctive modafinil treatment on residual excessive daytime sleepiness among nasal continuous positive airway pressure-treated japanese patients with obstructive sleep apnea syndrome: a double-blind placebo-controlled study. Journal of Clinical Sleep Medicine 9(8): 751-757, 2013

Effects of long term nasal continuous positive airway pressure on the blood pressure of patients with obstructive sleep apnea hypopnea syndrome. Zhonghua Jie he He Hu Xi Za Zhi 35(9): 687-690, 2012