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Objective Obstructive Sleep Apnea Syndrome (OSAS) causes multiple breathing interruptions during sleep and increases mortality if left untreated. Continuous positive airway pressure (CPAP) therapy improves the prognosis of OSAS; however, patient adherence is often poor. This study investigated the relationship between monthly hospital visits and CPAP adherence to CPAP therapy in patients with OSAS. Methods We studied 119 patients (93 men and 26 women) at the Minami Kyoto Hospital between June 2022 and May 2023. CPAP adherence was measured daily. Hospital/clinic visits were categorized as "Last minute visits at the end of the month" (≥25th of the month) and analyzed in relation to CPAP adherence. Results The average duration of CPAP use duration were 5 h, 47 min, and 43 s. Patients visiting on or after the 25th of month had significantly lower CPAP use (4 h, 17 min, 05 s) compared to those visiting before the 25th of month (6 h, 01 min, 47 s, p=0.003). No significant correlation was found between the visit frequency and adherence to CPAP therapy, with a lower visit frequency unexpectedly corresponding to longer CPAP use (p=0.04). Conclusion The timing of monthly clinic visits significantly affected CPAP adherence, with late-month visits associated with poorer adherence. Visit frequency showed no clear correlation with adherence, suggesting that other factors may have influenced CPAP use. Further supportive interventions can enhance adherence and improve the treatment outcomes.

Objective The effects of partial pressure of arterial oxygen (PaO 2 ) after introducing long-term noninvasive ventilation (NIV) on the prognosis of patients with restrictive thoracic disease and chronic respiratory failure are not exactly known. Methods Data from 141 patients with restrictive thoracic disease under long-term nocturnal NIV were retrospectively examined. We divided the patients into 2 groups according to the daytime PaO 2 value while breathing spontaneously with prescribed oxygen at 12 months after introducing NIV: PaO 2 ≥80 Torr group (n=76) and PaO 2 <80 Torr group (n=65). Results During the 4-year follow-up, the mortality was significantly higher in the PaO 2 <80 Torr group than in the PaO 2 ≥80 Torr group (50.8% vs. 32.9%, p=0.03). Independent factors associated with the 4-year mortality after introducing NIV determined by a multivariate logistic regression analysis were a low body mass index [odds ratio (OR) 0.87; 95% confidence interval (CI) 0.77 to 0.97; p=0.01], assisted mode with NIV (OR 4.11; 95% CI, 1.79 to 9.45; p=0.0009), hospitalization during the first year of introducing NIV (OR 1.72; 95% CI, 1.06 to 2.79; p=0.03), and daytime PaO 2 <80 Torr at 12 months after introducing NIV (OR 2.30; 95% CI, 1.03 to 5.10; p=0.04). Conclusion A low daytime PaO 2 at 12 months after introducing NIV was an independent risk factor for mortality. Keeping the daytime PaO 2 ≥80 Torr through the adjustment of the nocturnal NIV settings or increased diurnal supplemental oxygen may help improve the prognosis in patients with restrictive thoracic disease who are under NIV.