Abstract

NOGUEIRA, Juan F; BORSINI, Eduardo  and  NIGRO, Carlos. Estrategias para mejorar la adaptación al tratamiento con CPAP en pacientes con SAHOS. Rev. am. med. respir. [online]. 2016, vol.16, n.4, pp.365-377. ISSN 1852-236X.

Obstructive Sleep Apnea is a highly prevalent condition, associated with excessive daytime sleepiness; considerable risk for traffic accidents; cardiovascular, neurological and metabolic morbidity and increased health costs. CPAP treatment is the first choice for most patients who suffer from moderate to severe OSA. CPAP reverts respiratory events and OSA symptoms, as sleep quality, snoring and somnolence. On the other hand, it helps to control comorbidities. Patients should use CPAP as much time as they sleep, at least 4 hours per night, 5 or more nights a week. Efficacy depends on adherence to treatment. In general population, average CPAP compliance is around 50%, therefore, strategies for improving CPAP compliance are necessary. Educational programs, close follow up and patient´s training on CPAP usage clearly improve adherence. Correct pressure titration, adequate mask choice and adverse effects prevention are also key factors. Anxiety management and cognitive-behavioral strategies may help to increase patient willingness and commitment. Different technologic resources reduce mean CPAP pressure, increasing tolerance and potentially could enhance adherence to treatment. In patients who require high effective pressure alternative ventilatory modalities should be considered, such as auto adjust and bilevel devices. If sleep disturbed symptoms persist, another sleep disorders have to be excluded. Access to treatment is also a determining factor in developing countries.

Keywords : Sleep apnea; OSA; CPAP; Compliance; Adherence; Education.

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