Long term efficiency of azelastine hydrochloride and fluticasone propionate nasal spray to improve PAP adherence in patients with obstructive sleep apnea.

<bold>Background:</bold> The treatment of obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) devices often faces challenges in terms of adherence. This study is the effectiveness of INAH with placebo over 12 months in increasing PAP adherence and efficacy for alleviating symptoms of CPAP-induced rhinitis in patients with OSA. <bold>Methods:</bold> A prospective, open-label, follow-up study from patients who complete phase 1 study. The participants were divided into two groups based on the phase 1 study. The online questionnaires or calls for interviewing were sent to patients according to their preference and objectivity CPAP adherence and side effects were also obtained on the first day of the phase 2 study, at 3, 6, 9, and 12 months of phase 2 study. <bold>Results:</bold> Most patients had severe obstructive sleep apnea (OSA) with significant blockage during sleep (80.2%). The study found that the rate of CPAP device usage for more than 4 hours in the INAH group, compared to placebo group from the beginning, showed a significant difference at 9 months (62.66% vs. 40.04%, p = 0.025) and 12 months (63.55% vs. 36.77%, p = 0.03), with an overall average of 57.76% vs. 48.41% (p = 0.018). However, there were no significant differences in nasal symptoms. <bold>Conclusion:</bold> This study is the first of its kind to evaluate the long-term effectiveness of azelastine hydrochloride and fluticasone propionate nasal spray in improving adherence to PAP therapy. Results suggest INAH significantly increases in CPAP adherence at 12 months