An orientation session improves objective sleep quality and mask acceptance during positive airway pressure titration

Abstract

The aim of this study was to determine whether an orientation session led by a polysomnography (PSG) technician during the night of positive airway pressure (PAP) titration can improve objective sleep quality and acceptance of nasal mask in patients referred to a sleep laboratory. Consecutive patients (n=1,481), referred for PAP titration during PSG, were retrospectively evaluated. Patients were distributed in two groups: the control group, patients referred for PAP titration (n=699) who did not undertake an orientation session led by a PSG technician, and the oriented group, patients referred to PAP titration (n=782) who followed the orientation session. Demographic data were similar (p > 0.05) between groups (control vs oriented) for: male/female proportion (76:24 vs 75:25%), age (mean +/- SD; 53 +/- 12 vs 52 +/- 12 years), Epworth Sleepiness Scale score (12 +/- 6 vs 12 +/- 6), and body mass index (31 +/- 6 vs 31 +/- 6 kg/m(2)). PSG data were different (p < 0.05) between the groups for: total sleep time (312 +/- 81 vs 326 +/- 85 min), sleep efficiency (74 +/- 17 vs 77 +/- 14%), sleep latency (22 +/- 24 vs 18 +/- 29 min), S1 (8 +/- 8 vs 6 +/- 5%), S3 4 (19 +/- 11 vs 21 +/- 13%), rapid eye movement sleep (17 +/- 9 vs 18 +/- 9%), and wake after sleep onset (106 +/- 68 vs 93 +/- 58 min). After the orientation session, the number of patients who did not accept nasal mask during PSG recording was higher in the control group than the oriented group (80 vs 44; p=0.001). An orientation session led by a PSG technician can improve objective sleep quality and nasal mask acceptance during the night of PAP titration. Such an addition to PAP titration could be an efficient intervention to improve PAP compliance.