2023, Number 3
<< Back Next >>
Acta de Otorrinolaringología CCC 2023; 51 (3)
Description of the frequency of poor adherence factors in positive airway pressure therapy (CPAP-BPAP-APAP) in patients with OSA belonging to the Central Military Hospital of Colombia between 2015-2020
Valderrama-Penagos JX, Dueñas-Quintero KL, Guzmán-Ortiz KA
Language: Spanish
References: 19
Page: 212-221
PDF size: 243.61 Kb.
ABSTRACT
Introduction: Obstructive sleep apnea (OSA) is a complex condition with multiple
causative factors contributing to poor adherence to positive pressure systems since
problems with device and conditions inherent to the patient. This study aims to
describe the frequency of such factors reported in the literature for patients treated
between 2015-2020.
Methods: Observational, descriptive, case series study. The
medical history was reviewed, and a survey was completed. Clinical, physical,
and device-related variables were characterized and described.
Results: 26 patients
were analyzed in this study, 76.9% were male and 23.1% female. The average age
of the patients was 51.2 ± 13.2 years. The body mass index (BMI) was 27.8, of
which only 7 patients had a normal index (‹25; 26.9%). 10 patients at the time of
the first consultation do not have daytime sleepiness (38.5%). The apnea hypopnea
index (AHI) was on average 37.4/hour ± 17.5. 6 patients with treatment pressure
less than or equal to 8 cmH2O (30%) and 14 patients with pressure greater (70%).
The residual AHI was on average 8.3 events/hour ± 10.1.
Conclusions: The frequency
of factors associated with poor treatment adherence underscores the need
for comprehensive psychosocial assessments, detailed clinical histories, and thorough
physical assessment to identify barriers to adherence and develop effective
therapeutic strategies.
REFERENCES
Copur AS, Erik Everhart D, Zhang C, Chen Z, Shekhani H,Mathevosian S, et al. Effect of personality traits on adherencewith positive airway pressure therapy in obstructive sleep apneapatients. Sleep Breath. 2018 May;22(2):369-76. doi: 10.1007/s11325-017-1559-5
Chen YF, Hang LW, Huang CS, Liang SJ, Chung WS.Polysomnographic predictors of persistent continuous positiveairway pressure adherence in patients with moderate and severeobstructive sleep apnea. Kaohsiung J Med Sci. 2015;31(2):83-9. doi: 10.1016/j.kjms.2014.11.004
Akashiba T, Inoue Y, Uchimura N, Ohi M, Kasai T, KawanaF, et al. Sleep Apnea Syndrome (SAS) Clinical PracticeGuidelines 2020. Respir Investig. 2022;60(1):3-32. doi:10.1016/j.resinv.2021.08.010
Carrillo Alduenda JL, Arreondo del Bosque FM, Reyes ZúñigaM, Castorena Maldonado A, Vázquez García JC, Torre-Bouscoulet L. Síndrome de apnea obstructiva del sueño enpoblación adulta. Neumol Cir Torax. 2010;69(2):103-15.
Luo K, Zhang L, Zhang X, Han T, Li Y, Wang C. Acceptanceof and six-month adherence to continuous positive airwaypressure in patients with moderate to severe obstructive sleepapnea. Clin Respir J. 2021;15(1):56-64. doi: 10.1111/crj.13269
Bravata DM. Identifying predictors of adherence to positiveairway pressure: the next step in implementing sleep apneamanagement for patients with cerebrovascular events. SleepMed. 2020;66:241-42. doi: 10.1016/j.sleep.2020.01.005
Mehrtash M, Bakker JP, Ayas N. Predictors of ContinuousPositive Airway Pressure Adherence in Patients withObstructive Sleep Apnea. Lung. 2019;197(2):115-21. doi:10.1007/s00408-018-00193-1
Picard F, Panagiotidou P, Weinig L, Steffen M, Tammen AB,Klein RM. Effect of CPAP therapy on nocturnal blood pressurefluctuations, nocturnal blood pressure, and arterial stiffness inpatients with coexisting cardiovascular diseases and obstructivesleep apnea. Sleep Breath. 2021;25(1):151-61. doi: 10.1007/s11325-020-02075-4
Drager LF, Malhotra A, Yan Y, Pépin JL, Armitstead JP,Woehrle H, et al. Adherence with positive airway pressuretherapy for obstructive sleep apnea in developing vs. developedcountries: a big data study. J Clin Sleep Med. 2021;17(4):703-9. doi: 10.5664/jcsm.9008
Engleman HM, Wild MR. Improving CPAP use by patientswith the sleep apnoea/hypopnoea syndrome (SAHS). SleepMed Rev. 2003;7(1):81-99. doi: 10.1053/smrv.2001.0197
Catcheside PG. Predictors of continuous positive airwaypressure adherence. F1000 Med Rep. 2010;2:70. doi: 10.3410/M2-70
McArdle N, Devereux G, Heidarnejad H, Engleman HM,Mackay TW, Douglas NJ. Long-term use of CPAP therapy forsleep apnea/hypopnea syndrome. Am J Respir Crit Care Med.1999;159(4 Pt 1):1108-14. doi: 10.1164/ajrccm.159.4.9807111
Nino-Murcia G, McCann CC, Bliwise DL, GuilleminaultC, Dement WC. Compliance and side effects in sleep apneapatients treated with nasal continuous positive airway pressure.West J Med. 1989;150(2):165-9.
Hoffstein V, Viner S, Mateika S, Conway J. Treatment ofobstructive sleep apnea with nasal continuous positive airwaypressure. Patient compliance, perception of benefits, and sideeffects. Am Rev Respir Dis. 1992;145(4 Pt 1):841-5. doi:10.1164/ajrccm/145.4_Pt_1.841
Sawyer AM, Gooneratne NS, Marcus CL, Ofer D, RichardsKC, Weaver TE. A systematic review of CPAP adherence acrossage groups: clinical and empiric insights for developing CPAPadherence interventions. Sleep Med Rev. 2011;15(6):343-56.doi: 10.1016/j.smrv.2011.01.003
Van Ryswyk E, Anderson CS, Antic NA, Barbe F, Bittencourt L,Freed R, et al. Predictors of long-term adherence to continuouspositive airway pressure in patients with obstructive sleepapnea and cardiovascular disease. Sleep. 2019;42(10):zsz152.doi: 10.1093/sleep/zsz152
Zampogna E, Spanevello A, Lucioni AM, Facchetti C, SotgiuG, Saderi L, et al. Adherence to Continuous Positive AirwayPressure in patients with Obstructive Sleep Apnoea. A ten yearreal life study. Respir Med. 2019;150:95-100. doi: 10.1016/j.rmed.2019.02.017
Weaver TE. Novel Aspects of CPAP Treatment and Interventionsto Improve CPAP Adherence. J Clin Med. 2019;8(12):2220.doi: 10.3390/jcm8122220
Aalaei S, Rezaeitalab F, Tabesh H, Amini M, Afsharisaleh L,Mostafavi SM, et al. Factors Affecting Patients’ Adherence toContinuous Positive Airway Pressure Therapy for ObstructiveSleep Apnea Disorder: A Multi-Method Approach. Iran J MedSci. 2020;45(3):170-78. doi: 10.30476/ijms.2019.45785