Factors that influence CPAP adherence: an overview

Shapiro, Gilla K.; Shapiro, Colin M.

doi:10.1007/s11325-010-0391-y

Cited by 155 publications

(107 citation statements)

References 81 publications

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“…Hawkins, MD 1,2 ; Emily L. Jensen, BS 3,4 may result in development of the aforementioned comorbidities, compromised daily functioning, increased health care utilization, and contribution to early mortality. 6,[15][16][17][18][19][20][21][22][23] OSA severity, pressure settings, and mask type, have not been found to affect use, 14,[24][25][26][27][28][29][30] whereas psychosocial factors and perception of OSA's importance do. 14,23,31 One study suggested that higher maternal education correlated with higher adherence.…”

Section: Correlates Of Pediatric Cpap Adherencementioning

confidence: 99%

Correlates of Pediatric CPAP Adherence

Hawkins

Jensen

Simon

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Obstructive sleep apnea (OSA) is a common pediatric condition characterized by recurrent partial or complete cessation of airflow during sleep, typically due to inadequate upper airway patency. Continuous positive airway pressure (CPAP) is a therapeutic option that reduces morbidity. Despite efforts to promote use, CPAP adherence is poor in both pediatric and adult populations. We sought to determine whether demographics, insurance status, OSA severity, therapeutic pressure, or comorbid conditions were associated with pediatric CPAP adherence. Methods: A retrospective review of adherence download data was performed on all pediatric patients with initiation or adjustment of CPAP treatment over a one-year period with documented in-laboratory CPAP titration. Patients were grouped as CPAP adherent or non-adherent, where adherence was defined as > 70% nightly use and average usage ≥ 4 hours per night. Differences between the groups were analyzed by χ 2 test. Results: Overall, nearly half of participants were CPAP adherent (49%, 69/140). Of the demographic data collected (age, ethnicity, sex, insurance status), only female sex was associated with better adherence (60.9% vs 39.5% of males adherent; odds ratio [OR] = 2.41, 95%CI = 1.20-4.85; p = 0.01). Severity of OSA (diagnostic apnea-hypopnea index [AHI] and degree of hypoxemia), therapeutic pressure, and residual AHI did not impact CPAP adherence (p > 0.05). Patients with developmental delay (DD) were more likely to be adherent with CPAP than those without a DD diagnosis (OR = 2.55, 95%CI = 1.27-5.13; p = 0.007). Female patients with trisomy 21 tended to be more adherent, but this did not reach significance or account for the overall increased adherence associated with female sex. Conclusions: Our study demonstrates that adherence to CPAP therapy is poor but suggests that female sex and developmental delay are associated with better adherence. These findings support efforts to understand the pathophysiology of and to develop adherence-promoting and alternative interventions for pediatric OSA.

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Section: Correlates Of Pediatric Cpap Adherencementioning

confidence: 99%

Correlates of Pediatric CPAP Adherence

Hawkins

Jensen

Simon

et al. 2016

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

show abstract

“…16 Oxygen administration has been used as an alternative treatment in patients with OSA who are not somnolent or not compliant with CPAP; the purpose of supplemental oxygen in this situation is to reduce the deleterious effects of transient hypoxemia during sleep. 17 Supplemental oxygen has been shown to be effective in improving the AHI, respiratory arousal index, and nocturnal desaturation during apneic episodes.…”

mentioning

confidence: 99%

Obstructive Sleep Apnea and Oxygen Therapy: A Systematic Review of the Literature and Meta-Analysis

Mehta

Vasu

Phillips

et al. 2013

Journal of Clinical Sleep Medicine

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“…15 Common side effects related to CPAP use include pressure intolerance, dryness of nasal and pharyngeal membranes, nasal symptoms, and eye irritation. 16 Recent advancements in mask designs provide better mask fit and more selections to the patients that may provide more positive CPAP experiences and increased compliance. There are concerns in the field that use of nasal pillows at higher CPAP pressure may lead to more CPAP related side effects such as nasal symptoms and jetting.…”

Section: Discussionmentioning

confidence: 99%