Behavioral Training for Increasing Preschool Children's Adherence With Positive Airway Pressure: A Preliminary Study

Slifer, Keith J.; Kruglak, Deborah; Benore, Ethan; Bellipanni, Kimberly; Falk, Lori; Halbower, Ann C.; Amari, Adrianna; Beck, Melissa

doi:10.1080/15402000701190671

Cited by 48 publications

(26 citation statements)

References 26 publications

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“…Behavioral interventions, including parent education and graded mask introduction, improve PAP adherence. [20][21][22] We hypothesize that in our subjects the positive effect of the RT visits was due to combined effects of education, mask optimization, coordination of equipment requirements with the durable medical equipment company, positive reinforcement, equipment check, and close followup. The relative contribution of each of these components could not be determined in this retrospective study.…”

Section: Discussionmentioning

confidence: 99%

Role of a Respiratory Therapist in Improving Adherence to Positive Airway Pressure Treatment in a Pediatric Sleep Apnea Clinic

et al. 2013

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BACKGROUND: Many pediatric patients need positive airway pressure (PAP) for treatment of obstructive sleep-disordered breathing. Adherence to PAP (defined as percent of nights with PAP use of > 4 h) is often poor and not sustained long-term. With any chronic disease, education has been shown to help with patient outcomes. Education of patients and parents regarding PAP can be provided by different healthcare professionals. There is no published literature assessing the role of respiratory therapists (RTs) in improving adherence to PAP in children. We hypothesized that the addition of RT visits to a PAP clinic would improve PAP adherence. METHODS: RT services for PAP patients were introduced in a multidisciplinary pediatric sleep clinic in May 2006. We identified children who had been followed in clinic, and had adherence download information before and after introduction of RT services. We collected demographic, polysomnography, and CPAP adherence data at clinic visits. RESULTS: Forty-six subjects met criteria for inclusion. The mean ؎ SD age was 14.9 ؎ 6 y. The mean ؎ SD apnea-hypopnea index was 26.7 ؎ 30 events/h. Other than the addition of the RT intervention, all subjects continued to receive the same clinical services as before. Subjects were divided into 3 groups, based on baseline adherence: 0% use, use for 1-50% of nights, and use for > 50% of nights. There was a statistically significant improvement in PAP adherence in the subjects with baseline use of 0% and 1-50%, but no improvement in those with > 50% use at baseline. There was no significant change in PAP use at subsequent RT visits. CONCLUSIONS: Utilization at clinic visits of an RT trained in the use of PAP improved adherence in pediatric subjects with obstructive sleep-disordered breathing when their baseline PAP adherence was < 50%.

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Section: Discussionmentioning

confidence: 99%

Role of a Respiratory Therapist in Improving Adherence to Positive Airway Pressure Treatment in a Pediatric Sleep Apnea Clinic

et al. 2013

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“…For example, one treatment for OSA is continuous positive airway pressure (CPAP), which may be initially uncomfortable and require desensitization (Marcus et al, 2006;O'Donnell, Bjornson, Bohn, & Kirk, 2006). Because adherence in children is the strongest barrier to CPAP use, behavioral interventions for improving CPAP adherence are important components in CPAP treatment (Slifer et al, 2007). For disorders such as RLS and parasomnias, recommendations for increasing sleep promoting behaviors and decreasing sleep interfering behaviors (collectively termed sleep hygiene) may reduce the frequency and severity of both disorders (Guilleminault, Palombini, Pelayo, & Chervin, 2003;Picchietti et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Behavioral Sleep Problems in Children and Adolescents

Moore

2012

J Clin Psychol Med Settings

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Sleep problems in children and adolescents are common, and they impact multiple domains of child and family functioning. Psychologists have a critical role in the assessment and treatment of sleep problems and are integral to interdisciplinary sleep teams. Certain sleep problems may be related to co-morbid psychological or developmental conditions, and others are considered to be primarily medical, yet behavioral approaches may be applicable. There are also sleep problems considered to be behavioral in etiology (e.g. inadequate sleep hygiene, behavioral insomnia of childhood, nightmares/bad dreams/nighttime fears, delayed sleep phase syndrome, and psychophysiological insomnia). In this article, the assessment of behavioral sleep problems, as well as specific behavioral sleep disorders, and their treatments will be discussed.

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“…Behavioral treatments (e.g., extinction, graduated extinction, preventive education) have also been empirically validated in the treatment of bedtime problems and night wakings in young children, resulting in a recent standards of practice statement for their efficacy by the American Academy of Sleep Medicine (AASM; Morgenthaler, Owens et al, 2006). Recent studies have also shown that behavioral approaches can improve adherence to positive airway pressure (PAP), a common, yet somewhat unpleasant treatment for obstructive sleep apnea in adults (Aloia, Arnedt, Stepnowsky, Hecht, & Borrelli, 2005;Aloia et al, 2007) and children (Marcus et al, 2006;Slifer et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Clinical psychology training in sleep and sleep disorders

2009

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There is growing evidence to suggest that clinical psychologists would benefit from more training in sleep and sleep disorders. Sleep disturbances are commonly comorbid with mental health disorders and this relationship is often bidirectional. In addition, psychologists have become integral members of multidisciplinary sleep medicine teams and there are not enough qualified psychologists to meet the clinical demand. The purpose of this study was to evaluate the current education on sleep and sleep disorders provided to clinical psychology predoctoral students and interns. Directors of graduate programs and internships (N = 212) completed a brief online survey on sleep education in their program. Only 6% of programs offers formal didactic courses in sleep, with 31% of programs offering training in the treatment of sleep disorders. There are few programs with sleep faculty (16%), and most reported that their institutions were ineffective in providing sleep education. Thirty-nine percent of training directors reported they would implement a standard curriculum on sleep, if available. The findings from this study suggest that more opportunities are needed for trainees in clinical psychology to gain didactic and clinical experience with sleep and sleep disorders.

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Behavioral Training for Increasing Preschool Children's Adherence With Positive Airway Pressure: A Preliminary Study

Cited by 48 publications

References 26 publications

Role of a Respiratory Therapist in Improving Adherence to Positive Airway Pressure Treatment in a Pediatric Sleep Apnea Clinic

Role of a Respiratory Therapist in Improving Adherence to Positive Airway Pressure Treatment in a Pediatric Sleep Apnea Clinic

Behavioral Sleep Problems in Children and Adolescents

Clinical psychology training in sleep and sleep disorders

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