Factors related to positive airway pressure therapy adherence in children with obesity and sleep-disordered breathing
| Autor: | Linda Horwood, Sherri L. Katz, Joanna E. MacLean, Bethany J. Foster, Lynda Hoey, Laurent Legault, Mary-Ann Harrison, Glenda N. Bendiak, Valerie G. Kirk, Stasia Hadjiyannakis, Evelyn Constantin, Nick Barrowman |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty 03 medical and health sciences 0302 clinical medicine Sleep Apnea Syndromes Internal medicine mental disorders Positive airway pressure medicine Humans Obesity Child Continuous Positive Airway Pressure business.industry Therapy adherence medicine.disease Scientific Investigations respiratory tract diseases Obstructive sleep apnea Neurology Cardiology Breathing Sleep disordered breathing Noninvasive ventilation Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | J Clin Sleep Med |
| Popis: | 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. CITATION: Katz SL, Kirk VG, MacLean JE, et al. Factors related to positive airway pressure therapy adherence in children with obesity and sleep-disordered breathing. J Clin Sleep Med. 2020;16(5):733–741. |
| Databáze: | OpenAIRE |
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