Associations of diabetes mellitus and hypertension with adherence to continuous positive airway pressure therapy in male patients with obstructive sleep apnea

Shigeko Kojima; Ayako Saito; Fumihiko Sasaki; Masamichi Hayashi; Yuki Mieno; Hiroki Sakakibara; Shuji Hashimoto

doi:10.20407/fmj.2020-028

Associations of diabetes mellitus and hypertension with adherence to continuous positive airway pressure therapy in male patients with obstructive sleep apnea

Fujita Med J. 2022 May;8(2):37-41. doi: 10.20407/fmj.2020-028. Epub 2021 Aug 20.

Authors

Shigeko Kojima¹, Ayako Saito², Fumihiko Sasaki³, Masamichi Hayashi⁴, Yuki Mieno⁵, Hiroki Sakakibara⁶, Shuji Hashimoto²

Affiliations

¹ Department of Rehabilitation, Faculty of Health Sciences, Nihon Fukushi University, Handa, Aichi, Japan.
² Department of Hygiene, School of Medicine, Fujita Heath University, Toyoake, Aichi, Japan.
³ SDB Research Laboratory, Takaoka Clinic, Nagoya, Aichi, Japan.
⁴ Division of Respiratory Medicine, Fujita Health University Okazaki Medical Center, Okazaki, Aichi, Japan.
⁵ Department of Respiratory Medicine, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
⁶ Tokushige Kokyuki Clinic, Nagoya, Aichi, Japan.

Abstract

Methods: We conducted a retrospective study among 497 male patients with OSA on CPAP therapy. Participants with pretreatment Apnea-Hypopnea Index (AHI) data based on overnight polysomnographic recordings completed a questionnaire. Adherence data for CPAP therapy were collected using a smart card system. We classified CPAP use of ≥4 hours per night and ≥70% of nights as good adherence; other CPAP use was categorized as poor adherence. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for poor adherence to CPAP therapy in the hypertension and diabetes mellitus groups, compared with the no comorbidity group, adjusting for body mass index, duration of CPAP therapy, AHI, and Epworth Sleepiness Scale score.

Results: In the no comorbidity, hypertension, and diabetes mellitus groups, 43.4%, 44.7%, and 56.0%, respectively, had poor adherence to CPAP therapy. Being in the diabetes mellitus group was significantly associated with poor adherence to CPAP therapy (OR=1.86, 95% CI: 1.18-2.92, p=0.007); there was no association for the hypertension group.

Conclusion: Our results indicate that comorbidity of diabetes mellitus is associated with poor adherence to CPAP therapy in male patients with OSA.

Keywords: Adherence; Continuous positive airway pressure; Diabetes mellitus; Hypertension; Obstructive sleep apnea.