CPAP adherence after osas surgery

The aim of our study is to measure the adherence of the usage of CPAP (Continuous Positive Airway Pressure) for the moderate-severe obstructive sleep apnea (OSA) patients had a operation as they refused CPAP theraphy and still need PAP (Positive Airway Pressure) treatment. The 80 patients undergone sleep surgery applied for sleep apnea,snoring and excessive daytime sleepiness and diagnosed OSAS whose Polisomnography (PSG) result is AHI>15 because of refusing the CPAP treatment were included to Akdeniz University of Medicine,Ear, Nose and Throat Department between June 2011 and January 2013. The study was continued with 67 patients excluding the 13 patients who didn't want to fill out the questionnaire and quit the routine follow. Those patients were questioned if they were using CPAP, if they had seen any obvious benefit or not from the CPAP treatment and adherence of the CPAP usage when they came to routine control. All data of the patients in the preoperative and postoperative periods were seperated and compared. patients in postoperative period were seperated as CPAP users and non-users and qualitive and quantitative values of those two groups were compared. 8 (11.9 %) of the patients participating in the study were female and 59 (88,1%) were male. 43 (64.2 %) of the 67 patients participating in the study nasal surgery, 60 ( 89,6 % ) of the patients oral surgery, 36 (53 %) of the patients combined surgery were performed. Preoperative Epworth Seepless Scala (ESS) values of the patients compared to postoperative period, ESS value after the operation was found to be a statistically significant decrease (p<0.01). Preoperative Apnea Hypoapnea Index values of the patients compared to postoperative period, AHI value after the operation was found to be a statistically significant decrease (p<0.01). In the postoperative period, 67 patients, AHI over 15 recomended to reuse CPAP, when queried; 31 patients (46.3 %) uses CPAP regulary, 3 (4.5 %) patients used CPAP irregular, 33 (49.3% ) patients didn't use CPAP at all is observed. In the postoperative period, preoperative minimum Oksygen values (pre O2 ) of the CPAP user patients compared to non-user patients, pre O2 value in CPAP user patients was found to be a statistically significant decrease (p<0.05). In the postoperative period, postoperative Epworth Sleepless Scala (post ESS ) of the CPAP user patients compared to non-user patients, post ESS value in CPAP user patients was found to be a statistically significant higher (p<0.05). In the postoperative period, postoperative Apnea Hypoapnea Index (post AHI) values of the CPAP user patients compared to non-user patients, post AHI value in CPAP user patients was found to be a statistically significant higher (p<0.01). In the postoperative period, postoperative supin Apnea Hypoapnea Index (post supin AHI) values of the CPAP user patients compared to non-user patients, post AHI value in CPAP user patients was found to be a statistically significant higher (p<0.05). In the postoperative period, postoperative minimum Oksygen values (post O2) of the CPAP user patients compared to non-user patients, post AHI value in CPAP user patients was found to be a statistically significant decrease (p<0.01). In the postoperative period, among the CPAP user and non-user patients, age, body mass indeks (BMI), neck circumference (NC), pre ESS, pre AHI, pre supin AHI values or gender features significant difference was not observed statistically. We observed that 34 of the 67 patients who absolutely refused CPAP treatment at first and preferred operation instead, have started to use CPAP as there is / was no other theatment option left. As a result of this, OSAS surgery provides positive effect for using CPAP where the disease continues. Consequently in our study we believe that; unimproved daytime sleepiness and reported AHI, supin AHI, minimum O2 saturation level disorders are significantly affective the patients, CPAP treatment acceptability after surgery Key words: CPAP adherence after surgery, OSAS surgery.