Outcome of Public Hospital-Funded Continuous Positive Airway Therapy Device for Patients with Obstructive Sleep Apnoea: An Australian Perspective Study

Heraganahally, Subash S.; Kerslake, Claire; Issac, Siji; Mingi, Joy J; Thomas, Izaak; Jayaram, Lata; Adams, Robert

doi:10.1007/s41782-020-00114-4

Cited by 14 publications

(13 citation statements)

References 26 publications

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“…Despite CPAP being established as a gold standard treatment modality for moderate to severe OSA, adherence to CPAP has consistently been noted to be low. 24,45,[48][49][50] The simulation model in our study illustrates that PT may be beneficial in most patients with POSA, even among patients with moderate to severe OSA. The overall simulated PT impact in this group of patients, although lesser than that of CPAP, still resulted in two-thirds of patients demonstrating clinically significant improvement.…”

Section: Discussionmentioning

confidence: 64%

<p>Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects</p>

Garg¹,

Er²,

Howarth³

et al. 2020

NSS

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Purpose: To assess the prevalence of positional sleep apnea (POSA) and its predictors in patients diagnosed to have obstructive sleep apnea (OSA) in the regional and remote population of the Northern Territory of Australia over a two-year study period (2018 and 2019). Patients and Methods: Of the total 1463 adult patients who underwent a diagnostic polysomnography (PSG), 946 patients were eligible to be included in the study, of them, 810 consecutive patients with OSA (Apnea-Hypopnea Index (AHI) ≥ 5) who slept >4 h and had ≥30 min sleep in both supine and lateral positions were assessed. Patients were considered to have POSA if supine AHI to lateral AHI ratio ≥2. The likely comparative impact of use of continuous positive airway therapy (CPAP) or positional therapy (PT) on disease severity was evaluated using model simulation. Results: A total of 495/810 (61%) patients had POSA, the majority were males (68% vs 60%, p=0.013) and non-Indigenous Australians (93% vs 87%, p=0.004). POSA patients were younger (mean difference 2.23 years (95% CI 0.27, 4.19)), less obese (BMI mean difference 3.06 (95% CI 2.11, 4.01)), demonstrated less severe OSA (p < 0.001) and a greater proportion reported alcohol consumption (72% vs 62%, p=0.001) as compared to those with non-POSA. Using the simulation model, if patients with POSA use PT two-thirds (323/495, 65%) would obtain significant improvement of their OSA severity, with one in five (92/495, 19%) displaying complete resolution. Comparing this to simulated CPAP therapy, where the majority (444/495, 90%) will show significant improvement, and onethird (162/495, 33%) will display complete resolution. Conclusion: POSA needs to be routinely recognised and positional therapy integrated in practice especially in the remote regions and in the developing world when effective methods are in place to monitor positional therapy.

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Section: Discussionmentioning

confidence: 64%

<p>Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects</p>

Garg¹,

Er²,

Howarth³

et al. 2020

NSS

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“…Indigenous people have a higher burden of chronic health conditions, including cardiorespiratory disorders, giving rise to higher morbidity and mortality [33][34][35][36][37]. Understanding the different clinical manifestations [38][39][40] and appropriate interventions [41][42][43][44][45][46][47][48][49][50] will help in early diagnosis and management of chronic health conditions in the Indigenous population, for better health related outcomes. Varying manifestations of sex differences in PFTP's have been demonstrated in this study, both with and without underlying radiological evidence of CADs among an Indigenous Australian cohort.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease

et al. 2022

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Background Studies assessing normative values and sex differences in pulmonary function test parameters (PFTPs) among Indigenous populations are sparse. Methods PFTPs were compared between male and female Indigenous Australian adults with and without chest radiologically proven chronic airway diseases (CADs). Results 485 adults (56% were female) with no significant difference in age, body mass index or smoking status between sexes were included. Females displayed a higher prevalence of radiology without CADs compared to males (66 vs. 52%, respectively). Among patients without CADs, after adjustment for age, stature and smoking, males displayed significantly higher absolute values of Forced Vital Capacity (FVC) (mean difference, 0.41L (0.21,0.62), p<0.001) and Forced Expiratory Volume in one second (FEV1) (mean difference 0.27L (0.07,0.47), p<0.001), with no significant difference in FEV1/FVC ratio (mean difference -0.02 (-0.06, 0.02), p = 0.174). Male and female patients with radiologically proven CADs demonstrated lower FEV1/FVC values. However, compared to females, males showed significantly greater reductions in pre- [-0.53 (-0.74, -0.32) vs. -0.29 (-0.42, -0.16), p = 0.045] and post- [-0.51 (-0.72, -0.3) vs. -0.27 (-0.39, -0.14), p = 0.049] bronchodilator FEV1. Conclusions There are significant sex differences in the PFTPs among Indigenous Australians. Recognising these differences may be of value in the accurate diagnosis, management, monitoring and prognostication of CADs in this population.

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“…Moreover, primary care physicians are more than often at the helm in the diagnosis and ongoing management of chronic respiratory conditions, in particular for patients living in the regional and remote communities [ 37 ]. Emerging evidence in the recent past suggests that understanding the different clinical manifestations and health care needs along with adopting to culturally and clinically relevant strategies in the diagnosis and management of chronic health conditions may lead to reducing the health gap amongst Indigenous population [ 38 – 42 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison and outcomes of emergency department presentations with respiratory disorders among Australian indigenous and non-indigenous patients

et al. 2022

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Background There is sparse evidence in the literature assessing emergency department presentation with respiratory disorders among Indigenous patients. The objective of this study was to evaluate the clinical characteristics and outcomes for Indigenous Australians in comparison to non-Indigenous patients presenting to Emergency Department (ED) with respiratory disorders. Methods In this study, two non-contiguous one-month study periods during wet (January) and dry (August) season were reported on, and differences in demographics, respiratory diagnosis, hospital admission, length of hospital stay, re-presentation to hospital after discharge and mortality between Australian Indigenous and non-Indigenous patients was assessed. Results There were a total of 528 respiratory ED presentations, 258 (49%) during wet and 270 (51%) in dry season, from 477 patients (52% female and 40% Indigenous). The majority of ED presentations (84%) were self-initiated, with a difference between Indigenous (80%) and non-Indigenous (88%) presentations. Indigenous presentations recorded a greater proportion of transfers from another healthcare facility compared to non-Indigenous presentations (11% vs. 1%). Less than half of presentations (42%) resulted in admission to the ward with no difference by Indigenous status. Lower respiratory tract infections were the most common cause of presentation (41%), followed by airway exacerbation (31%) which was more commonly seen among Indigenous (34%) than non-Indigenous (28%) presentations. Almost 20% of Indigenous patients reported multiple presentations to ED compared to 1% of non-Indigenous patients, though mortality on follow up did not differ (22% for both). Conclusions The results of this study may be an avenue to explore possibilities of implementing programs that may be helpful to reduce preventable ED presentation and recurrent hospitalisations among Indigenous population.

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Outcome of Public Hospital-Funded Continuous Positive Airway Therapy Device for Patients with Obstructive Sleep Apnoea: An Australian Perspective Study

Cited by 14 publications

References 26 publications

<p>Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects</p>

<p>Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects</p>

Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease

Comparison and outcomes of emergency department presentations with respiratory disorders among Australian indigenous and non-indigenous patients

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