Departmental Bulletin Paper Polysomnographic parameters during non-rapid eye movement sleep predict continuous positive airway pressure adherence

Hoshino, Tetsurou  ,  Sasanabe, Ryujiro  ,  Murotani, Kenta  ,  Arimoto, Mariko  ,  Inagawa, Shuntaro  ,  Tanigawa, Tohru  ,  Uchida, Yasue  ,  Ogawa, Tetsuya  ,  Ueda, Hiromi  ,  Shiomi, Toshiaki

78 ( 2 )  , pp.195 - 203 , 2016-05 , Nagoya University Graduate School of Medicine, School of Medicine
The aim of this study was to investigate the potential polysomnographic predictors of CPAP adherenceusing polysomnographic parameters at the time of obstructive sleep apnea diagnosis that distinguishedbetween REM and NREM sleep. This was a retrospective cross-sectional study of 173 patients. Patientswho used CPAP for more than 4 hours per night for at least 70% of nights over a 6-month period wereconsidered to have good adherence. The poor adherence group included those who had used CPAP for6 months from initiation, but did not fulfill the definition of good adherence or gave up the treatmentwithin 6 months of treatment initiation. Of the 173 participants, 44 patients had good CPAP adherenceand 129 patients had poor adherence. Univariate analysis showed that patients with good adherence hadsignificantly higher apnea-hypopnea index during NREM sleep (p = 0.043), oxygen desaturation indexduring NREM sleep (p = 0.011), and cumulative percentage of time spent at saturations below 90% (CT90)during NREM sleep (p < .001). In multiple logistic regression analysis including all variables, CT90 duringNREM sleep was the only factor independently associated with CPAP adherence (odds ratio, 0.693; 95%confidence interval, 0.582–0.824; p <.0001). The area under the receiver-operating characteristic curve ofCT90 during NREM sleep was 0.823 (95% confidence interval, 0.745–0.901).Evaluating NREM sleep isimportant in reliably predicting CPAP adherence using polysomnographic parameters. CT90 during NREMsleep was the best predictor of CPAP adherence.

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