Access to CPAP treatment in patients with moderate to severe sleep apnea in a Latin American City

Nogueira, Juan Facundo; Simonelli, Guido; Giovini, Vanina; Angellotti, María Florencia; Borsini, Eduardo; Ernst, Glenda; Nigro, Carlos

doi:10.5935/1984-0063.20180032

Cited by 11 publications

(21 citation statements)

References 57 publications

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“…The rate of good CPAP compliance in this study was quite low. It was comparable to that found in African-American patients with OSA (20.59% versus 21%) and lower than those found in White (45%) or Latino (56.3%) patients [12,13]. Possible explanations for the low CPAP compliance in these populations include low socioeconomic status, poor understanding of the consequences of OSA, cultural factors, short sleep duration, and insomnia [12,14,15].…”

Section: Discussionsupporting

confidence: 48%

Are symptoms of obstructive sleep apnoea related to good continuous positive airway pressure compliance?

2020

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Obstructive sleep apnoea (OSA) is a common disease that can be treated with continuous positive airway pressure (CPAP). CPAP tolerance may be associated with its compliance. Even though there are several predictors for good CPAP compliance, there are limited data available on the correlation between CPAP compliance and OSA symptoms. This study aimed to evaluate this correlation. We conducted a cross-sectional study and enrolled adult patients diagnosed with OSA through polysomnography who had experience using a CPAP machine. A self-report questionnaire was used to evaluate CPAP compliance and study variables. Predictors of CPAP compliance were analysed using stepwise multivariate logistic regression analysis. There were 68 patients with OSA who completed the questionnaire during the study period. Of those, 14 (20.59%) exhibited good CPAP compliance. Only fatigue as a symptom was an independent factor associated with good CPAP compliance, with an adjusted odds ratio of 5.380 (95% CI 1.274–22.719). In conclusion, fatigue was the only symptom associated with good CPAP compliance in patients with OSA.

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Section: Discussionsupporting

confidence: 48%

Are symptoms of obstructive sleep apnoea related to good continuous positive airway pressure compliance?

2020

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“…Carol et al reported that more than 90% of patients with moderate to severe OSA accepted CPAP treatment after manual titration or autotitration studies 11 . A study from a Latin American hospital reported that 71.8% of patients with moderate to severe OSA started CPAP treatment 12 . However, a study from western Iran reported that only 27.8% of OSA patients initiated CPAP treatment 13 .…”

Section: Discussionmentioning

confidence: 99%

Acceptance of and six‐month adherence to continuous positive airway pressure in patients with moderate to severe obstructive sleep apnea

Luo

Zhang

et al. 2020

Clinical Respiratory J

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Background Continuous positive airway pressure (CPAP) is the most effective treatment for moderate to severe obstructive sleep apnea (OSA). Acceptance of and adherence to CPAP are crucial for optimal treatment outcomes. The aim of this study was to investigate the factors influencing patients’ acceptance of and adherence to CPAP treatment. Methods One hundred eighty‐eight patients with moderate to severe OSA who had received CPAP titration from October 2017 to September 2018 were recruited. They were interviewed at 2 weeks and at 6 months to assess CPAP use and barriers to acceptance and adherence. Results One hundred fourteen patients (60.6%) accepted CPAP treatment. Disease severity, assessed by apnea‐hypopnea index (AHI) (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01‐1.08), subjective satisfaction of titration (OR, 12.83; 95% CI, 3.83‐42.99), initial intention of CPAP therapy (OR, 3.33; 95% CI, 1.05‐10.51) and short‐term home CPAP trial (OR, 9.40; 95% CI, 2.85‐31.08) were associated with acceptance of CPAP treatment. Two‐third of the 98 CPAP acceptors reported good CPAP adherence at 6 months follow‐up. Average hours of CPAP use per day for the first 2 weeks (OR, 1.88; 95% CI, 1.28‐3.04) and the global problems associated with CPAP use (OR, 0.82; 95% CI, 0.73‐0.91) were independent predictors of the six‐month CPAP adherence. Conclusions Nearly 40% of patients with moderate to severe OSA did not accept CPAP treatment, and one‐third of those CPAP acceptors had poor adherence to CPAP treatment. Improvement in disease awareness, comfortable titration experience, short‐term home CPAP trial may be of help to increase CPAP acceptance and early experience with CPAP is important for long‐term adherence. The differences in predicting factors for CPAP acceptance and adherence highlight the importance of focusing on specific aspects during the whole process management of OSA.

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“…It is worth highlighting that 25% of Chilean patients who stopped using CPAP alleged financial reasons 13 . In spite of having different health systems in terms of organization and financing, other under developed countries in our region have reported similar difficulties in CPAP acquirement [10][11][12][13] .…”

Section: Resultsmentioning

confidence: 88%

Compliance to Continuous Positive Airway Pressure therapy in patients with obstructive sleep apnea – long-term assessment

Pascua¹,

Blanco²,

Ernst³

et al. 2021

Sleep Sci

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Introduction:To assess CPAP acquirement, compliance, and dropout rates among OSA patients three years after the prescription. Material and Methods: We assessed CPAP acquirement (Acq), compliance (Comp), and dropout (Dout) through a telephone survey. We interviewed 156 patients; ESS: 9.9±5.7, AHI>15ev/hour in 96.4%. 92 patients had accessed CPAP therapy (58.9%) and 67 (72.8%) were still using it. Dropout was reported by 25 (27.2%). The Comp group was older (p<0.01), had more men (p<0.001), higher ESS scores (p<0.03) and a higher level of specialist follow-up (p<0.001). Multivariate analysis adjusted showed; follow-up by experts (OR: 4.39; p<0.05) and ESS>10 (OR: 1.25; p˂0.05) increased CPAP compliance. Conclusion: There is a high number of patients without CPAP therapy acquirement. Long-term compliance was found in ¾ of the study population in symptomatic patients followed up by specialists. Finally, 43% had effective treatment.

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Access to CPAP treatment in patients with moderate to severe sleep apnea in a Latin American City

Cited by 11 publications

References 57 publications

Are symptoms of obstructive sleep apnoea related to good continuous positive airway pressure compliance?

Are symptoms of obstructive sleep apnoea related to good continuous positive airway pressure compliance?

Acceptance of and six‐month adherence to continuous positive airway pressure in patients with moderate to severe obstructive sleep apnea

Compliance to Continuous Positive Airway Pressure therapy in patients with obstructive sleep apnea – long-term assessment

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