Effects of a Short Course of Eszopiclone on Continuous Positive Airway Pressure Adherence

摘要

Untreated obstructive sleep apnea (OSA) is associated with adverse effects on both health and quality of life (1, 2). Continuous positive airway pressure (CPAP) is recommended as first-line therapy for most patients to improve sleep quality, reduce daytime sleepiness, and enhance quality of life. It may also mitigate the increased risk for cardiovascular events (3-6). However, adherence to CPAP is often poor, which limits its efficacy. Of patients who initiate CPAP, approximately 50% discontinue use within the first year, most within the first month. The initial experience with CPAP influences who accepts and continues treatment (7). Patients who experience initial discomfort, intolerance, or lack of perceived benefit are more likely to discontinue therapy (8). Some studies suggest that psychosocial factors may also affect short- and intermediate-term adherence (9, 10). The only consistently reliable predictor of long-term adherence has been the use of CPAP during the initial treatment period (11). The average nightly CPAP use during the first 3 months of therapy can predict use at 6 and 12 months (12). Furthermore, longterm adherence patterns may be determined within the first few days of therapy (13). Therefore, strategies aimed at improving adherence with therapy should focus on the initial experience with CPAP.