What question did this study set out to answer?

The study aims to identify patient-reported causes affecting adherence to CPAP therapy among those with obstructive sleep apnea syndrome.

April 11, 2026Open Access

The Role of Side Effects in Adherence of Patients with Obstructive Sleep Apnea Syndrome to Continuous Positive Airway Pressure Therapy

Key Points

The study aims to identify patient-reported causes affecting adherence to CPAP therapy among those with obstructive sleep apnea syndrome.
Investigated 86 patients with a diagnosis of obstructive sleep apnea syndrome.
Divided participants into adherent and non-adherent groups based on CPAP usage.
Used questionnaires to capture side effects and reasons for suboptimal CPAP use.
Key causes for poor CPAP adherence included side effects from the mask, misperception of disease severity, and lack of confidence in therapy.
Dry mouth was the most reported side effect but was not a significant predictor of adherence.
Anxiety related to the CPAP device was significantly linked to suboptimal therapy use.

Abstract

Introduction: Continuous positive airway pressure (CPAP) therapy is the main therapeutic method for obstructive sleep apnea syndrome (OSAS).The way of accommodating the patient with the CPAP mask is very important for adherence to therapy.In this study, we tried to determine the patient-reported causes for suboptimal use of CPAP therapy and to draw up some recommendations for their management, with the aim to improve adherence to CPAP therapy. Materials and methods:The present study investigated 86 patients diagnosed with OSAS who were divided into two categories by CPAP adherence (at least four hours per night therapy in at least 70% of the recommended days): CPAP adherent patients (n = 50) and non-adherent patients (n = 36).All participants completed a questionnaire to report the side effects of therapy and the main reasons for suboptimal use of CPAP therapy.Results: The reported causes for the inappropriate use of therapy with statistical significance included side effects of the mask and device, misperception of disease severity and lack of confidence that CPAP therapy is useful for treating OSAS.Dry mouth, the main side effect reported by both adherent and non-adherent patients, was not a predictor of statistical significance for adherence to therapy.Suboptimal use of therapy, a statistically significant factor for adherence to treatment, occurred in some of the OSAS patients who developed anxiety related to CPAP device.Many non-adherent participants used an air humidifier attached to CPAP to treat dry mouth as a side effect, which did not help increase adherence in this group of patients.Conclusion: Multiple factors may be involved in OSAS patients' adherence to CPAP therapy.Of these, side effects in therapy can play an important role and resolving them can be an essential factor for patient adherence.

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