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Predictors of Continuous Positive Airway Pressure Adherence in Patients with Obstructive Sleep Apnea

  • M. Mehrtash
  • J. P. Bakker
  • N. AyasEmail author


Obstructive sleep apnea (OSA) is a common disease which impacts quality of life, mood, cardiovascular morbidity, and mortality. Continuous positive airway pressure (CPAP) is the first-line treatment for patients with moderate to severe OSA. CPAP ameliorates respiratory disturbances, leading to improvements in daytime sleepiness, quality of life, blood pressure, and cognition. However, despite the high efficacy of this device, CPAP adherence is often sub-optimal. Factors including: socio-demographic/economic characteristics, disease severity, psychological factors, and side-effects are thought to affect CPAP adherence in OSA patients. Intervention studies have suggested that augmented support/education, behavioral therapy, telemedicine and technological interventions may improve CPAP adherence. In this paper, we will extensively review the most common factors including age, gender, race/ethnicity, socioeconomic status, smoking status, severity of OSA, severity of OSA symptoms, psychological variables, social support, marital status/bed partner involvement, dry nose and mouth, mask leak, and nasal congestion that may predict CPAP adherence. We will also extensively review interventions that may increase adherence to CPAP.


Continuous positive airway pressure (CPAP) Obstructive sleep apnea (OSA) Adherence CPAP adherence 


Author contributions

All authors contributed substantially to this work.


Ms. Mehrtash was partially supported by the Canadian Sleep and Circadian Network (CSCN) which is funded by CIHR.

Compliance with ethical standards

Conflict of interest

Jessie Bakker is a full-time employee of Philips Respironics, a company that focuses on sleep and respiratory care. She has a part-time appointment at Brigham and Women’s Hospital. Dr. Bakker’s interests were reviewed and are managed by BWH and Partners HealthCare in accordance with their conflict of interest policies. Dr. Ayas is part of the Scientific Advisory Board of Bresotec, a company that makes diagnostic sleep apnea equipment.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Experimental Medicine Program, Department of MedicineUniversity of British Columbia (UBC)VancouverCanada
  2. 2.Sleep Disorders ProgramUBC HospitalVancouverCanada
  3. 3.Division of Sleep & Circadian DisordersBrigham and Women’s HospitalBostonUSA
  4. 4.Respiratory and Critical Care Divisions, Department of MedicineUBCVancouverCanada

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