scholarly journals 702 Patient Characteristics & Positive Airway Pressure Therapy Compliance During NYC’s 2020 COVID-19 Pandemic Stay-at-Home Orders

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A274-A274
Author(s):  
Sunil Nair ◽  
Alcibiades Rodriguez
Keyword(s):  
Sleep Apnea ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sleep Problems ◽  
Control Period ◽  
Patient Characteristics ◽  
Pressure Therapy ◽  
And Control ◽  
At Home

Abstract Introduction During the first surge of the COVID-19 pandemic in New York City, as New Yorkers were enjoined by authorities to stay-at-home, patient encounters were transitioned from office visits to telemedicine consultations. It was thought that increased stress during the pandemic would worsen rates of insomnia, and concerns regarding use of positive airway pressure (PAP) therapy during a respiratory pandemic would affect compliance. We sought to describe telemedicine success rates, the distribution of sleep problems evaluated remotely by telemedicine, and PAP compliance in our patient population. Methods Telemedicine encounters from March 16th through May 31st, 2020, were reviewed for show-rates, patient characteristics and clinician impressions, and were compared to administrative data from the 2.5 months prior to the stay-at-home period (the “control period”). PAP compliance was analyzed for forty randomly selected patients established on PAP therapy between January 1st and October 1st, 2019, and whose machines transmitted data to a digital management system between October 1st and December 31st, 2019. Compliance reports and AHI were compared between the stay-at-home- and control- periods for this randomly selected group of patients. Results The telemedicine show rate was 89.37% (compared to a 91.91% in-office show-rate during the control period); all these encounters were successfully completed. Sleep apnea was the predominant diagnosis during the stay-at-home period (44.33% of encounters), followed by insomnia (23.16%). Insomnia complaints were significantly higher during the stay-at-home period compared to the control period (23.16% versus 14.6% of encounters; p < .05), and among new- versus follow-up- patients (41.76% versus 35.99%). PAP compliance and AHI, however, were not statistically different for forty randomly selected patients between the control and stay-at-home periods. Conclusion Most stay-at-home period telemedicine encounters were successful. Sleep apnea, then insomnia, were common findings among new and follow-up patients during the stay-at-home period, and insomnia rates increased during the pandemic. PAP compliance and AHI were similar in a random cohort when compared between the stay-at-home and control periods. Support (if any):

scholarly journals The Effect of Continuous Positive Airway Pressure Therapy on Obstructive Sleep Apnea-Related Hypertension

2021 ◽  
Vol 22 (5) ◽  
pp. 2300
Author(s):  
Ronni Baran ◽  
Daniela Grimm ◽  
Manfred Infanger ◽  
Markus Wehland
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Common Disease ◽  
Cpap Therapy ◽  
Pressure Therapy ◽  
Airway Patency ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) is a common disease, with approximately 3–7% of men and 2–5% of women worldwide suffering from symptomatic OSA. If OSA is left untreated, hypoxia, microarousals and increased chemoreceptor stimulation can lead to complications like hypertension (HT). Continuous positive airway pressure (CPAP) is the most common treatment for OSA, and it works by generating airway patency, which will counteract the apnea or hypopnea. More than one billion people in the world suffer from HT, and the usual treatment is pharmacological with antihypertensive medication (AHM). The focus of this review will be to investigate whether the CPAP therapy for OSA affects HT.

scholarly journals Positive Airway Pressure Therapy Adherence with Mask Resupply: A Propensity-Matched Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 720
Author(s):  
Adam Benjafield ◽  
Liesl Oldstone ◽  
Leslee Willes ◽  
Colleen Kelly ◽  
Carlos Nunez ◽  
...  
Keyword(s):  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Group Versus ◽  
Control Group ◽  
Billing Data ◽  
Pressure Therapy ◽  
Therapy Termination ◽  
Few Data ◽  
And Control ◽  
The Impact

There are currently few data on the impact of mask resupply on longer-term adherence to positive airway pressure (PAP) therapy. This retrospective analysis investigated the effects of mask/mask cushion resupply on the adherence to PAP versus no resupply. Deidentified patient billing data for PAP supply items were merged with telemonitoring data from Cloud-connected AirSense 10/AirCurve 10 devices via AirViewTM (ResMed). Eligible patients started PAP between 1 July 2014 and 17 June 2016, had ≥360 days of PAP device data, and achieved initial U.S. Medicare adherence criteria. Patients who received a resupply of mask systems/cushions (resupply group) were propensity-score-matched with those not receiving any mask/cushion resupply (control group). A total of 100,370 patients were included. From days 91 to 360, the mean device usage was 5.6 and 4.5 h/night in the resupply and control groups, respectively (p < 0.0001). The proportion of patients with a mean device usage ≥4 h/night was significantly higher in the resupply group versus the control group (77% vs. 59%; p < 0.0001). The therapy termination rate was significantly lower in the resupply group versus the control group (14.7% vs. 31.9%; p < 0.0001); there was a trend toward lower therapy termination rates as the number of resupplies increased. The replacement of mask interface components was associated with better longer-term adherence to PAP therapy versus no resupply.

scholarly journals Randomized controlled trial of an integrated approach to treating insomnia and improving the use of positive airway pressure therapy in veterans with comorbid insomnia disorder and obstructive sleep apnea

SLEEP ◽  
2020 ◽  
Author(s):  
Cathy A Alessi ◽  
Constance H Fung ◽  
Joseph M Dzierzewski ◽  
Lavinia Fiorentino ◽  
Carl Stepnowsky ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sleep Onset ◽  
Apnea Hypopnea Index ◽  
Sleep Onset Latency ◽  
Pressure Therapy ◽  
Comorbid Insomnia ◽  
Obstructive Sleep

Abstract Study Objectives Cognitive behavioral therapy for insomnia (CBTI) for comorbid insomnia and obstructive sleep apnea (OSA) has had mixed results. We integrated CBTI with a positive airway pressure (PAP) adherence program and tested effects on sleep and PAP use. Methods 125 veterans (mean age 63.2, 96% men, 39% non-Hispanic white, 26% black/African American, 18% Hispanic/Latino) with comorbid insomnia and newly-diagnosed OSA (apnea-hypopnea index ≥ 15) were randomized to 5-weekly sessions integrating CBTI with a PAP adherence program provided by a “sleep coach” (with behavioral sleep medicine supervision), or 5-weekly sleep education control sessions. Participants and assessment staff were blinded to group assignment. Outcomes (baseline, 3 and 6 months) included Pittsburgh Sleep Quality Index (PSQI), 7-day sleep diary (sleep onset latency [SOL-D], wake after sleep onset [WASO-D], sleep efficiency [SE-D]), 7-day actigraphy (SE-A), and objective PAP use (hours/night and nights ≥ 4 h). Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10) were also collected. Results Compared to controls, intervention participants showed greater improvement (baseline to 3 and 6 months, respectively) in PSQI (−3.2 and −1.7), SOL-D (−16.2 and −15.5 minutes), SE-D (10.5% and 8.5%), SE-A (4.4% and 2.6%) and more 90-day PAP use (1.3 and 0.9 more hours/night, 17.4 and 11.3 more nights PAP ≥ 4 h). 90-day PAP use at 3 months was 3.2 and 1.9 h/night in intervention versus controls. Intervention participants also had greater improvements in ISI, ESS, and FOSQ-10 (all p &lt; 0.05). Conclusions An intervention integrating CBTI with a PAP adherence program delivered by a supervised sleep coach improved sleep and PAP use in adults with comorbid insomnia and OSA. Trial Registration ClinicalTrials.gov Study name: Novel Treatment of Comorbid Insomnia and Sleep Apnea in Older Veterans URL: https://clinicaltrials.gov/ct2/results?cond=&term=NCT02027558&cntry=&state=&city=&dist= Registration: NCT02027558

Effect of personality traits on adherence with positive airway pressure therapy in obstructive sleep apnea patients

2017 ◽  
Vol 22 (2) ◽  
pp. 369-376 ◽  
Author(s):  
Ahmet Sinan Copur ◽  
D. Erik Everhart ◽  
Chao Zhang ◽  
Zhengjia Chen ◽  
Haris Shekhani ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Personality Traits ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Pressure Therapy ◽  
Positive Airway Pressure Therapy ◽  
Obstructive Sleep
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