Is a close follow-up program crucial for treatment adherence in patients with obstructive sleep apnea syndrome (OSAS)?

<bold>Background:</bold> OSAS is a chronic sleep disorder characterized by repeated episodes of upper airway obstruction during sleep. Continuous positive airway pressure (CPAP) helps keeping the upper airways open and is one of the most efficient treatments for OSAS. However, using the pressurized mask can be cumbersome and CPAP nonadherence is a significant barrier to OSAS treatment, shown to be as low as 29%. <bold>Aim:</bold> Evaluate CPAP adherence after one year of a close follow-up program. <bold>Methods:</bold> A retrospective study in our sleep clinic in 2020 of 434 patients with OSAS (71% male, mean (SD) age 53 y (13), Apnea-Hypopnea Index (AHI) 31 (20)). Patients were diagnosed and initiated for CPAP treatment by a sleep specialist after in-home polygraphy, and simultaneously received mask adaption and were briefed by a trained nurse about the importance of the treatment and how to use the CPAP device. In our one-year treatment follow-up program, all patients received a letter or/and a phone call after 4 and 12 weeks, including treatment data and information regarding device adjustments. CPAP data were accessed, and necessary adjustments were done, by a digital cloud-based system. All weekdays, nurses were available on telephone/SMS for support to meet individual challenges and for extra follow-up visits if needed. After one year, a last follow-up visit was arranged to summarize the CPAP treatment and address potential challenges related to the treatment. <bold>Results:</bold> After one year, the adherence to CPAP treatment was 83% while 17% discontinued. <bold>Conclusion:</bold> A close follow-up program with individually guided support, seems to be a success criterion for CPAP adherence in patients with OSAS.