Low Socioeconomic Status Is a Risk Factor for CPAP Acceptance Among Adult OSAS Patients Requiring Treatment

Simon‐Tuval, Tzahit; Reuveni, Haim; Greenberg-Dotan, Sari; Oksenberg, Arie; Tal, Asher; Tarasiuk, Ariel

doi:10.1093/sleep/32.4.545

Cited by 153 publications

(136 citation statements)

References 58 publications

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“…Financial incentive compared to a control group was shown to be an independent predictor of initial CPAP acceptance among OSA patients in a low-income group in Israel, although CPAP adherence rate was no different at 35% and 39% respectively at the one-year follow up 20 . The same authors reported that the odds of CPAP acceptance increased by 140% for each increase in the income level category in another study from Israel 21 . In Japan where all forms of medical treatment including CPAP are paid for by a national healthcare scheme, similar results on CPAP compliance were found.…”

Section: Discussionmentioning

confidence: 88%

Acceptance and Adherence to Continuous Positive Airway Pressure Therapy in patients with Obstructive Sleep Apnea (OSA) in a Southeast Asian privately funded healthcare system

Lee¹,

Leow²,

Song³

et al. 2017

Sleep Sci

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Background: There is limited data on long term Continuous Positive Airway Pressure (CPAP) adherence in Southeast Asian countries. This is a prospective study on CPAP adherence among Obstructive sleep apnea (OSA) patients in a Southeast Asian privately funded healthcare system. Methods: Patients with moderate-severe OSA who had been initiated on CPAP at least one year previously were contacted for a scripted telephone interview to assess compliance and factors associated with CPAP adherence. Results: Of 135 consecutive patients diagnosed to have moderate to severe OSA, 78 (57.8%) were initiated on CPAP treatment while 57 (42.2%) rejected CPAP upfront. 41 (52.6%) who initiated CPAP remained adherent at one year. OSA severity (AHI, ODI) and symptomatic improvement after CPAP were associated with better adherence. Presence of machine related side effects was associated with lower adherence. Inconvenience, cost and poor disease perception were reported as major barriers to uptake of CPAP therapy. Conclusions: In this Southeast Asian privately funded healthcare system, almost half of all patients with significant OSA rejected CPAP treatment upfront, but adherence among those who started CPAP is comparable to other reports. Challenges with CPAP acceptance as well as CPAP adherence need to be addressed to improve outcomes.

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Section: Discussionmentioning

confidence: 88%

Acceptance and Adherence to Continuous Positive Airway Pressure Therapy in patients with Obstructive Sleep Apnea (OSA) in a Southeast Asian privately funded healthcare system

Lee¹,

Leow²,

Song³

et al. 2017

Sleep Sci

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“…Each individual's lifestyle, sleeping habits, and clinical history were recorded using a standardized selfadministered questionnaire. [30][31][32] The Epworth Sleepiness Scale (ESS) was used to evaluate daytime sleepiness.…”

Section: Subjectsmentioning

confidence: 99%

Breathing and Snoring Sound Characteristics during Sleep in Adults

Levartovsky

Dafna

Zigel

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Sound level meter is the gold standard approach for snoring evaluation. Using this approach, it was established that snoring intensity (in dB) is higher for men and is associated with increased apnea-hypopnea index (AHI). In this study, we performed a systematic analysis of breathing and snoring sound characteristics using an algorithm designed to detect and analyze breathing and snoring sounds. The effect of sex, sleep stages, and AHI on snoring characteristics was explored. Methods: We consecutively recruited 121 subjects referred for diagnosis of obstructive sleep apnea. A whole night audio signal was recorded using noncontact ambient microphone during polysomnography. A large number (> 290,000) of breathing and snoring (> 50 dB) events were analyzed. Breathing sound events were detected using a signal-processing algorithm that discriminates between breathing and nonbreathing (noise events) sounds. Results: Snoring index (events/h, SI) was 23% higher for men (p = 0.04), and in both sexes SI gradually declined by 50% across sleep time (p < 0.01) independent of AHI. SI was higher in slow wave sleep (p < 0.03) compared to S2 and rapid eye movement sleep; men have higher SI in all sleep stages than women (p < 0.05). Snoring intensity was similar in both genders in all sleep stages and independent of AHI. For both sexes, no correlation was found between AHI and snoring intensity (r = 0.1, p = 0.291).Conclusions: This audio analysis approach enables systematic detection and analysis of breathing and snoring sounds from a full night recording. Snoring intensity is similar in both sexes and was not affected by AHI.

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“…NA ϭ not applicable equipment is 2-3 times higher than in other countries. 16,17 Elderly patients with a higher economic status are able to pay for their health maintenance. However, some older patients with lower economic status choose not to treat OSA because they are struggling with costs of other agingrelated medical problems.…”

Section: Cpap Acceptance In Subjects Of Different Agesmentioning

confidence: 99%

Beneficial Effects of Long-Term CPAP Treatment on Sleep Quality and Blood Pressure in Adherent Subjects With Obstructive Sleep Apnea

et al. 2015

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BACKGROUND: Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular diseases. Although CPAP is the first treatment choice for moderate-to-severe OSA, acceptance of and adherence to CPAP remain problematic. High CPAP adherence is generally defined as >4 h of use/night for >70% of the nights monitored. We investigated the long-term beneficial effects of CPAP on sleep quality and blood pressure in subjects with moderate-to-severe OSA according to high or low CPAP adherence. METHODS: We retrospectively analyzed 121 subjects with moderate-to-severe OSA from August 2008 to July 2012. These subjects were divided into 3 groups: (1) no CPAP treatment (n ‫؍‬ 29), (2) low CPAP adherence (n ‫؍‬ 28), and (3) high CPAP adherence (n ‫؍‬ 64). All subjects were followed up for at least 1 y. The 3 groups were compared regarding anthropometric and polysomnographic variables, presence of cardiovascular comorbidities, and blood pressure at baseline and at the last follow-up. RESULTS: The no-treatment group showed significant increases in oxygen desaturation index and blood pressure. The high-adherence group showed significant improvement in daytime sleepiness, apnea-hypopnea index (AHI), oxygen desaturation index, and blood pressure. Although the AHI was also significantly decreased after CPAP treatment in the lowadherence group, blood pressure remained unchanged. CONCLUSIONS: CPAP treatment had beneficial effects on both sleep quality and blood pressure only in subjects with OSA and high CPAP adherence who used CPAP for >4 h/night for >70% of nights monitored. Subjects with low CPAP adherence received beneficial effects on AHI, but not blood pressure.

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Low Socioeconomic Status Is a Risk Factor for CPAP Acceptance Among Adult OSAS Patients Requiring Treatment

Cited by 153 publications

References 58 publications

Acceptance and Adherence to Continuous Positive Airway Pressure Therapy in patients with Obstructive Sleep Apnea (OSA) in a Southeast Asian privately funded healthcare system

Acceptance and Adherence to Continuous Positive Airway Pressure Therapy in patients with Obstructive Sleep Apnea (OSA) in a Southeast Asian privately funded healthcare system

Breathing and Snoring Sound Characteristics during Sleep in Adults

Beneficial Effects of Long-Term CPAP Treatment on Sleep Quality and Blood Pressure in Adherent Subjects With Obstructive Sleep Apnea

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