How has continuous positive airway pressure (CPAP) adherence in obstructive sleep apnea (OSA) been assessed?

Updated: Sep 15, 2020
  • Author: Himanshu Wickramasinghe, MD, MBBS; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

CPAP adherence has often been assessed outside the context of adherence in other areas of medicine. In that context, CPAP adherence rates appear dismal.

However, in a prospective study of severe OSA patients investigating whether adherence or nonadherence to CPAP treatment predicted adherence to 3 well-known protective cardiovascular medications, CPAP adherence did not predict adherence with these medications. [123] The adherence with the medications was not surprisingly low, given what is known about adherence (81-95% adherence to the medication). Again, with severe OSA (AHI > 30) and comorbid heart disease, medication adherence was low, despite CPAP adherence.

In another study, patients who consistently refilled lipid-lowering medications were more adherent to CPAP. [174] However, being married was the most powerful predictor of adherence. Once marital status entered the regression model, CPAP adherence and medication adherence were not significant predictors of adherence. This study demonstrates the complexity of the assessment of adherence.


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