Compliance with continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea among privately paying patients- a cross sectional study.

BACKGROUND: To evaluate the compliance, benefits and side effects associated with continuous positive airway pressure (CPAP) therapy among Pakistani patients treated for obstructive sleep apnea (OSA) in private sector. METHODS: Patients diagnosed to have OSA based on overnight study who were recommended for CPAP therapy, between 1998 and 2003, were evaluated by telephonic survey and review of hospital notes. Compliance, benefits and side effects associated with CPAP therapy were assessed. RESULTS: Out of 135 patients who were prescribed CPAP therapy, 75 could be contacted. Sixty (80%) started using CPAP within one month of diagnosis and 46 (61%) continued to use it long-term (beyond one year). Compliance with CPAP therapy was associated with higher body mass index, higher Epworth sleepiness scale score, history of witnessed apnea, and reduction in daytime sleepiness with CPAP therapy. OSA severity as assessed by apnea-hypopnea index did not affect compliance with CPAP therapy. Use of anti-depressants and CPAP induced sleep disturbances were associated with poor compliance with CPAP therapy. CONCLUSIONS: Obesity, excessive daytime sleepiness, witnessed apnea and improvement of daytime symptoms following use of CPAP were predictors of improved compliance. Use of antidepressants and CPAP induced sleep disturbances were predictors of poor compliance.

Complementary and Alternative Medicine: Perceptions of Medical Students from Pakistan.

BACKGROUND: In view of the increasing popularity of complementary and alternative medicine (CAM), it is imperative that medical students, the health professionals of tomorrow, possess adequate knowledge on the topic. OBJECTIVES: This is a descriptive study designed to assess the knowledge, attitudes and behavior of medical students about CAM and to capture their perceptions and opinions about its integration into the medical curriculum. METHODS: A questionnaire-based cross-sectional survey was done on 198 medical students selected randomly from a Pakistani medical college. Associations between different variables were tested using the χ2-test of significance. RESULTS: Among the 198 participants, a majority believed that some of the CAM modalities are useful; they lacked knowledge, however, about their safety and efficacy. Most of the students believed that it should be used in conjunction with conventional medicine and that, if given adequate training, they would incorporate it in their future medical practice. One-third of the respondents voted in favor of incorporation of CAM into the medical curriculum. CONCLUSION: Despite being aware of the usefulness of CAM only a few medical students had pursued further knowledge. In order to prepare the medical students of today to better fulfill their duties as tomorrow's physicians, consideration should be given to incorporating CAM in the medical curriculum.