Mask side-effects in long-term CPAP-patients impact adherence and sleepiness: the InterfaceVent real-life study

Abstract Background For some patients, Continuous Positive Airway Pressure (CPAP) remains an uncomfortable therapy despite the constant development of technological innovations. To date, no real life study has investigated relationship between mask related side-effects (MRSEs) and CPAP-non-adherence (defined as < 4 h/day) or residual-excessive-sleepiness (RES, Epworth-Sleepiness-Scale (ESS) score ? 11) in long-term. Methods The InterfaceVent-CPAP is a prospective real-life cross-sectional conducted apneic adult cohort undergoing at least 3 months CPAP with unrestricted mask-access (34 different masks). MRSEs were evaluated using visual-analogue-scales, CPAP-data CPAP-software, sleepiness ESS. Results 1484 patients included analysis (72.2% male, median age 67 years (IQ 25–75 : 60–74), initial Apnea–Hypopnea-Index (AHI) 39 (31–56)/h, residual AHI flow was 1.9 (0.9–4) events/h), CPAP-treatment lasted 4.4 (2.0–9.7) years, CPAP-usage 6.8 (5.5–7.8) h/day, prevalence 8.6%, RES 16.17%. Leak-related most prevalent (patient-reported leaks concerned 75.4% responders had correlation CPAP-reported-leaks). Multivariable logistic regression analyses evaluating explanatory-variable (demographic data, device/mask data MRSEs) effects on variables-of-interest (CPAP-non-adherence RES), indicated for patient-MRSEs significant associations between: (i) dry-mouth (p = 0.004); (ii) patient-reported 0.007), noisy 0.001), dry nose 0.001) harness pain 0.043). Conclusion In long-term CPAP-treated leak-related remain side-effects, but cannot be predicted by CPAP-reported-leaks. Patient-MRSEs can independently associated RES, thus implying complementary role MRSE questionnaires alongside CPAP-device-reported-data patient monitoring. Trial registration InterfaceVent registered ClinicalTrials.gov (NCT03013283).