Can Sleep Hypoxic Measures Predict Long-Term Adherence to Positive Airway Pressure Treatments?
- 1Institute of Respiratory Disease, Department of Translational Biomedicine and Neuroscience, University "Aldo Moro", 70124 Bari, Italy.
- 2Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", 70124 Bari, Italy.
Abstract
Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder characterized by recurrent upper airway collapse. Continuous positive airway pressure (CPAP) is the gold standard treatment but is burdened by low adherence rates. Nighttime hypoxia may alter sleep structure and OSA symptoms, potentially affecting PAP treatment adherence. This study aims to evaluate whether nocturnal hypoxia measures could predict long-term PAP adherence. We conducted a real-life, retrospective study including 207 OSA patients. Clinical data were collected on symptoms, comorbidities, home sleep apnea test (HSAT) metrics, prescribed therapy and objective adherence data via in-built device software. Nocturnal respiratory failure (NRF) was defined as a total sleep time with SpO₂ < 90% (TST90) ≥ 30%. Among the cohort, 119 patients met the criteria for NRF. These patients exhibited higher BMI, more severe OSA and a higher prevalence of COPD compared to those without NRF. At follow-up, patients with NRF demonstrated significantly better treatment adherence and more frequently reported improvement in several daytime and nighttime symptoms. Time-to-event analysis and adjusted multivariable regressions showed a higher probability of good long-term PAP adherence in patients with TST90 ≥ 30%. These findings suggest that prolonged nocturnal hypoxemia may identify a subgroup of patients more likely to maintain long-term PAP treatment.
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BibTeX
@article{portacci2026sleep,
title = {{Can Sleep Hypoxic Measures Predict Long-Term Adherence to Positive Airway Pressure Treatments?}},
author = {Andrea Portacci and Sara Quaranta and Carla Santomasi and Valentina Di Lecce and Vitaliano Nicola Quaranta and Monica Amendolara and Ilaria Dei Lazzaretti and Laura Anna Sara Cuccaro and Massimo Casparrini and Sebastiano Spierto and Vito Picerno and Cristina Derobertis and Alfredo Vozza and Silvano Dragonieri and Giovanna Elisiana Carpagnano},
journal = {Clocks \& sleep},
year = {2026},
month = sep,
doi = {10.3390/clockssleep8040061},
url = {https://europepmc.org/article/MED/42924737},
note = {CC BY},
}
RIS
TY - JOUR
TI - Can Sleep Hypoxic Measures Predict Long-Term Adherence to Positive Airway Pressure Treatments?
AU - Andrea Portacci
AU - Sara Quaranta
AU - Carla Santomasi
AU - Valentina Di Lecce
AU - Vitaliano Nicola Quaranta
AU - Monica Amendolara
AU - Ilaria Dei Lazzaretti
AU - Laura Anna Sara Cuccaro
AU - Massimo Casparrini
AU - Sebastiano Spierto
AU - Vito Picerno
AU - Cristina Derobertis
AU - Alfredo Vozza
AU - Silvano Dragonieri
AU - Giovanna Elisiana Carpagnano
PY - 2026
DA - 2026/09/28
JO - Clocks & sleep
DO - 10.3390/clockssleep8040061
UR - https://europepmc.org/article/MED/42924737
AB - Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder characterized by recurrent upper airway collapse. Continuous positive airway pressure (CPAP) is the gold standard treatment but is burdened by low adherence rates. Nighttime hypoxia may alter sleep structure and OSA symptoms, potentially affecting PAP treatment adherence. This study aims to evaluate whether nocturnal hypoxia measures could predict long-term PAP adherence. We conducted a real-life, retrospective study including 207 OSA patients. Clinical data were collected on symptoms, comorbidities, home sleep apnea test (HSAT) metrics, prescribed therapy and objective adherence data via in-built device software. Nocturnal respiratory failure (NRF) was defined as a total sleep time with SpO₂ < 90% (TST90) ≥ 30%. Among the cohort, 119 patients met the criteria for NRF. These patients exhibited higher BMI, more severe OSA and a higher prevalence of COPD compared to those without NRF. At follow-up, patients with NRF demonstrated significantly better treatment adherence and more frequently reported improvement in several daytime and nighttime symptoms. Time-to-event analysis and adjusted multivariable regressions showed a higher probability of good long-term PAP adherence in patients with TST90 ≥ 30%. These findings suggest that prolonged nocturnal hypoxemia may identify a subgroup of patients more likely to maintain long-term PAP treatment.
SN - 2624-5175
ER -