Demographics, sleep apnea and positive airway pressure (PAP) treatment-related characteristics associated with PAP adherence: A large retrospective community-based longitudinal observational study

Alvarez, Jonathan Villa; Dales, Robert; Kendzerska, Tetyana

doi:10.1016/j.sleep.2022.06.017

Cited by 8 publications

(3 citation statements)

References 28 publications

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“…13,15,16 The study also agrees with observational studies reporting better adherence to PAP therapy in males than females. 33,34 The CCI was used in the present study to predict mortality for patients with several comorbid conditions. We found no significant difference in CCI between the adherent and non-adherent groups, thus supporting no increased risk of mortality between groups, yet a higher rate of hospitalization was linked with increased non-adherence.…”

Section: Discussionmentioning

confidence: 99%

Positive airway pressure therapy adherence and outcomes in obstructive sleep apnea: An exploratory longitudinal retrospective randomized chart review

Stevens,

Title,

Spurr

et al. 2024

Canadian Journal of Respiratory Therapy

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Background Positive airway pressure (PAP) therapy is prescribed to patients with obstructive sleep apnea (OSA). A commonly used definition for PAP therapy adherence is based upon the minimum requirements to receive Medicare coverage in the US, defined as PAP usage of four or more hours per night on 70 percent of nights for at least 30 consecutive days. However, little evidence exists to support this definition for PAP therapy adherence. Therefore, the present study sought to determine the efficacy of the present definition of PAP therapy adherence on longitudinal outcomes in patients with OSA, using objectively measured PAP device usage time. Methods An exploratory longitudinal, retrospective, randomized chart review was done to assess clinical outcomes between patients with OSA who were defined as PAP therapy adherent (n=50) and non-adherent (n=50) during an eight-year observation period. Results No significant differences were shown between groups for mortality, hospitalizations, or development of co-morbidities during the observation period. However, logistic regression showed significantly higher odds of adherence in male patients compared to female patients (OR=8.519; 95%CI=1.301–55.756; p=0.025) and significantly lower odds of adherence in patients with higher normal (OR=0.039; 95%CI=0.005–0.392; p=0.003), mild excessive (OR=0.039; 95%CI=0.003–0.517; p=0.014), and severe excessive (OR=0.088; 95%CI=0.012–0.635; p=0.016) daytime sleepiness compared to patients with lower normal daytime sleepiness. An increasing number of hospitalizations also corresponded with a significant decrease in odds of being adherent (OR=0.741; 95%CI=0.551–0.995; p=0.046). Conclusion The present study supports a steadily growing body of literature calling for more consideration and evidence to support a definition of PAP therapy adherence that is clinically meaningful.

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Section: Discussionmentioning

confidence: 99%

Positive airway pressure therapy adherence and outcomes in obstructive sleep apnea: An exploratory longitudinal retrospective randomized chart review

Stevens,

Title,

Spurr

et al. 2024

Canadian Journal of Respiratory Therapy

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“…Por otro lado, encuentran que un IMC elevado y un valor elevado del índice Apnea-Hipopnea (IAH) se asocian con una mayor mejora en el IAH tras el tratamiento con CPAP, mientras que la diabetes está vinculada a una mejora menor del IAH (40,41). En el mismo sentido, resaltan que el uso de NBSH se relaciona con una mayor adherencia al tratamiento, promoviendo un uso más frecuente y prolongado de la CPAP (42).…”

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“…Por último, encuentran que la poliposis nasal se asocia con un mayor riesgo de un uso insuficiente de la CPAP (47), además, indican que, la edad avanzada y una menor saturación de oxígeno mínima en el inicio del estudio se asocian con una mayor adherencia (41). Se describe cómo la adherencia mejora con el tiempo y que el IAH y el cumplimiento en la primera noche de uso son factores predictivos del cumplimiento a largo plazo (48).…”

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Actualización sobre la Terapia de Presión Positiva Continua en las Vías Respiratorias como Tratamiento del Síndrome de Apnea del Sueño

Minchala León,

Encalada Torres

2023

Salud ConCienc.

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Introducción: la Apnea Obstructiva del Sueño (AOS) se caracteriza por episodios recurrentes de colapso parcial o total de las vías respiratorias superiores durante el sueño, la prevalencia en adultos entre 54 a 93 años superaba el 60%, con una AOS de moderada a grave en el 30,3% de los individuos de etnia blanca, el 32,4% de afroamericanos, 38,2% de hispanos y el 39,4% de ascendencia china. Objetivo: Describir la actualización sobre la terapia de presión positiva continua en las vías respiratorias como tratamiento del síndrome de apnea del sueño. Metodología: se realizó una revisión bibliográfica tipo narrativa, los estudios fueron recogidos de diferentes bases de datos como Medline, Lilacs, TripDataBase, Cochrane Library, Epistemonikos, Scopus, mediante identificación-cribado-elegibilidad-selección y basado en el rango de calidad de Scimago Journal Rank. Resultados: se encontraron múltiples efectos del tratamiento, se demostró mejoras significativas en la somnolencia y calidad de vida. También se observó un impacto positivo en la depresión y ligera mejora en las funciones neurocognitivas. Además, mostró beneficios en la prevención de accidentes cerebrovasculares y fibrilación auricular. La adherencia al CPAP se vio influenciada por factores socioeconómicos, psicológicos y efectos secundarios de las mascarillas. Estos hallazgos sugieren la eficacia y la relevancia del tratamiento con CPAP en pacientes con AOS, así como la importancia de considerar múltiples factores para mejorar la adherencia y los resultados del tratamiento.

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Novel concept of personalized therapy with continuous positive airway pressure

Yamauchi,

Moritsuchi,

Hamada

2024

Sleep Breath

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Demographics, sleep apnea and positive airway pressure (PAP) treatment-related characteristics associated with PAP adherence: A large retrospective community-based longitudinal observational study

Cited by 8 publications

References 28 publications

Positive airway pressure therapy adherence and outcomes in obstructive sleep apnea: An exploratory longitudinal retrospective randomized chart review

Positive airway pressure therapy adherence and outcomes in obstructive sleep apnea: An exploratory longitudinal retrospective randomized chart review

Actualización sobre la Terapia de Presión Positiva Continua en las Vías Respiratorias como Tratamiento del Síndrome de Apnea del Sueño

Novel concept of personalized therapy with continuous positive airway pressure

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