Factors related to positive airway pressure therapy adherence in children with obesity and sleep-disordered breathing.

Autor:	Katz SL; Children's Hospital of Eastern Ontario/University of Ottawa, Ottawa, Ontario, Canada.; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada., Kirk VG; Alberta Children's Hospital/University of Calgary, Calgary, Alberta, Canada., MacLean JE; Stollery Children's Hospital/University of Alberta, Edmonton, Alberta, Canada., Bendiak GN; Alberta Children's Hospital/University of Calgary, Calgary, Alberta, Canada., Harrison MA; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada., Barrowman N; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada., Hoey L; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada., Horwood L; Montreal Children's Hospital/McGill University, Montreal, Quebec, Canada., Hadjiyannakis S; Children's Hospital of Eastern Ontario/University of Ottawa, Ottawa, Ontario, Canada., Legault L; Montreal Children's Hospital/McGill University, Montreal, Quebec, Canada., Foster BJ; Montreal Children's Hospital/McGill University, Montreal, Quebec, Canada., Constantin E; Montreal Children's Hospital/McGill University, Montreal, Quebec, Canada.
Jazyk:	angličtina
Zdroj:	Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine [J Clin Sleep Med] 2020 May 15; Vol. 16 (5), pp. 733-741. Date of Electronic Publication: 2020 Feb 07.
DOI:	10.5664/jcsm.8336
Abstrakt:	Study Objectives: Positive airway pressure (PAP) is used to treat children with concurrent obesity and sleep-disordered breathing (SDB), but achieving adherence remains challenging. We aimed to identify factors associated with PAP adherence in a prospective cohort of children with obesity prescribed PAP for newly diagnosed SDB. Methods: A questionnaire to assess factors related to PAP adherence was administered to participants and their parent ≥12 months after enrollment. Adherence (PAP use ≥4 hours/night on >50% of nights) was measured with PAP machine downloads, diaries, and physician assessments. Questionnaire responses were compared between adherent/nonadherent participants and between children/parents. Age, total and obstructive apnea-hypopnea index (OAHI), lowest oxygen saturation, and highest carbon dioxide were compared between adherent/nonadherent children with univariate differences of medians, with 95% confidence intervals. Results: Fourteen children (median age: 14.3 years; 93% male; all with obstructive sleep apnea) were included. Eleven (79%) were adherent to PAP. SDB symptom improvement was reported in 9 of 14 children (64%); 8 of 14 children (57%) had positive experiences with PAP. Most children assumed an active role in PAP initiation and felt supported by the clinical team. Responses between adherent/nonadherent groups and between children/parents were similar. Oxygen saturation nadir (median difference between nonadherent and adherent groups: 8.9%; 95% confidence interval: 1.7, 16.1), but not age, apnea-hypopnea index, OAHI, or maximum carbon dioxide, was associated with PAP adherence. Conclusions: Children with obesity-related SDB with lower nocturnal oxygen saturation nadir were more likely to adhere to PAP therapy. Ensuring adequate understanding of PAP therapy and medical team support are key factors in PAP success. (© 2020 American Academy of Sleep Medicine.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu