Adherence to Positive Airway Pressure Therapy
| Autor: | Rami Arfoosh, James A. Rowley |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
business.industry Excessive daytime sleepiness Apnea General Medicine medicine.disease respiratory tract diseases Psychiatry and Mental health Clinical Psychology Neuropsychology and Physiological Psychology Quality of life Internal medicine Positive airway pressure medicine Cardiology Neurology (clinical) Expiration medicine.symptom Airway business Intensive care medicine Hypopnea Oxygen saturation (medicine) |
| Zdroj: | Sleep Medicine Clinics. 5:321-334 |
| ISSN: | 1556-407X |
| DOI: | 10.1016/j.jsmc.2010.05.012 |
| Popis: | Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common medical disorder 1 characterized by recurrent episodes of either complete (apnea) or partial (hypopnea) upper airway collapse and obstruction during sleep. These episodes of obstruction are associated with recurrent oxyhemoglobin desaturations and arousals from sleep. Recent literature clearly shows that OSAHS is associated with significant clinical sequelae including excessive daytime sleepiness, 2 decreased quality of life, 3 metabolic abnormalities 4,5 and cardiovascular morbidity and mortality. 6,7 Positive airway pressure (PAP) therapy is the mainstay of therapy for moderateto-severe OSAHS. PAP therapy works primarily by mechanically splinting the upper airway, preventing the soft tissues from collapsing. By this mechanism, PAP effectively eliminates apneas and hypopneas, decreases recurrent arousals, and normalizes oxygen saturation. Evolving evidence suggests that PAP treatment leads to improvement in the sequelae of OSAHS. 6,8–10 Nevertheless adherence to the prescribed treatment has been less than ideal and is a major challenge for sleep specialists and primary providers. Currently, PAP devices commonly used for OSAHS come in three modalities: continuous PAP (CPAP), bilevel PAP (BPAP), and automatic self-adjusting PAP (APAP). CPAP devices generate a fixed continuous pressure during inspiration and expiration. In BPAP, the pressure alternates between a fixed inspiratory and lower expiratory level during the respiratory cycle. In APAP, the pressure changes throughout the night in response to changes in airflow, respiratory events, and snoring. This article will discuss the scope of the problem with compliance to PAP therapy and highlight recent research on the interventions to improve adherence with PAP. The words adherence and compliance will be used interchangeably in this article. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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