Partial failure of CPAP treatment for sleep apnoea: Analysis of the French national sleep database

Respirology ◽  
2019 ◽  
Vol 25 (1) ◽  
pp. 104-111 ◽  
Author(s):  
Sébastien Bailly ◽  
Najeh Daabek ◽  
Ingrid Jullian‐Desayes ◽  
Marie Joyeux‐Faure ◽  
Marc Sapène ◽  
...  
Thorax ◽  
1999 ◽  
Vol 54 (2) ◽  
pp. 147-149 ◽  
Author(s):  
A Boudewyns ◽  
V Grillier-Lanoir ◽  
M J Willemen ◽  
W A De Cock ◽  
P H Van de Heyning ◽  
...  

2012 ◽  
Vol 123 (2) ◽  
pp. 310-317 ◽  
Author(s):  
Andrew Vakulin ◽  
Peter G. Catcheside ◽  
Stuart D. Baulk ◽  
Nick A. Antic ◽  
Cameron J. van den Heuvel ◽  
...  

2014 ◽  
Vol 6 (3) ◽  
pp. 221 ◽  
Author(s):  
Jessie Bakker ◽  
Karyn O’Keeffe ◽  
Alister Neill ◽  
Angela Campbell

INTRODUCTION: Continuous positive airway pressure (CPAP) is an effective treatment of obstructive sleep apnoea (OSA), but can be limited by poor adherence. In New Zealand (NZ), ethnicity has been shown to be a predictor of CPAP adherence. This study aimed to explore Maori, Pacific and NZ European patients’ experience of CPAP treatment. METHODS: Patients identifying as Maori, Pacific, or NZ European ethnicity referred for CPAP treatment for OSA attended separate, 1.5-hour group discussions facilitated by a health care worker of the same ethnic group, using an interview template. Thematic analysis was applied to the discussion transcripts independently by two investigators, following published guidelines. FINDINGS: Five Maori, five Pacific, and eight NZ Europeans participated (mean age 47, range 30–71 years, mean ± standard deviation CPAP adherence 6.32 ±1.25 hours/night). Patients in all three groups reported that they had little knowledge of OSA or CPAP prior to treatment initiation. All groups identified barriers to treatment (both at the CPAP initiation phase and long term), reported feelings of being ‘overwhelmed’ with information during the initial CPAP education session, and discussed the importance of successful role models. Family and friends were generally reported as being supportive of CPAP therapy. CONCLUSION: The three groups all reported similar initial CPAP experiences, highlighting access barriers to publicly funded assessment and treatment pathways, and sleep health knowledge as key issues. Educational resources to improve access, enable self-management, and increase community awareness of OSA would help overcome some of the issues identified in this study. KEYWORDS: Continuous positive airway pressure; obstructive sleep apnea; ethnic groups; focus groups


2019 ◽  
Vol 8 (11) ◽  
pp. 1872 ◽  
Author(s):  
Grace Oscullo ◽  
Gerard Torres ◽  
Francisco Campos-Rodriguez ◽  
Tomás Posadas ◽  
Angela Reina-González ◽  
...  

Hypertension is one of the most frequent cardiovascular risk factors. The population of hypertensive patients includes some phenotypes whose blood pressure levels are particularly difficult to control, thus putting them at greater cardiovascular risk. This is especially true of so-called resistant hypertension (RH) and refractory hypertension (RfH). Recent findings suggest that the former may be due to an alteration in the renin–angiotensin–aldosterone axis, while the latter seems to be more closely related to sympathetic hyper-activation. Both these pathophysiological mechanisms are also activated in patients with obstructive sleep apnoea (OSA). It is not surprising, therefore, that the prevalence of OSA in RH and RfH patients is very high (as reflected in several studies) and that treatment with continuous positive airway pressure (CPAP) manages to reduce blood pressure levels in a clinically significant way in both these groups of hypertensive patients. It is therefore necessary to incorporate into the multidimensional treatment of patients with RH and RfH (changes in lifestyle, control of obesity and drug treatment) a study of the possible existence of OSA, as this is a potentially treatable disease. There are many questions that remain to be answered, especially regarding the ideal combination of treatment in patients with RH/RfH and OSA (drugs, renal denervation, CPAP treatment) and patients’ varying response to CPAP treatment.


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