Sex differences regarding the impact of a standardized adaptation session in Colombian patients with obstructive sleep apnea and poor adherence to positive airway pressure devices
Introduction: Positive airway pressure (PAP) is the most effective treatment for obstructive sleep apnea (OSA) but adherence is poor. The Sleep-disordered breathing clinic of Fundación Neumológica Colombiana (FNC) has a standardized adaptation session (SAS) aimed at patients with difficulties in using PAP devices. Objective: To evaluate the impact of a SAS in short-term adherence to PAP therapy in patients with OSA and to determine sex differences. Materials and methods: Before-after single cohort study conducted in 40 people aged ≥ 18 years with an AHI ≥ 15/hour and treated at the FNC, Bogotá D.C. (Colombia) between 2015 and 2017, and who attended a SAS due to poor adherence to PAP therapy (defined as <4 hours use in 70% of nights). Data on the hours of use of the PAP device and the % of days in which it was used >4 hours were recorded before and after the intervention to evaluate changes in patients’ adherence. Descriptive statistics were used for data analysis. The paired samples t-test was used for the comparison of variables before and after the intervention. Results: A significant increase was observed in the PAP device use (1.8 hours, 95%CI: 1.3-2.3; p<0.001) and in the % of days its use was >4 hours (35.6%, 95%CI: 26.0-45.3; p<0.001); in men the increase was greater in both cases (2.3 hours, 95%CI: 1.7-2.9; p=0.029 and 47.8%, 95%CI: 32.9-62.8; p=0.029). Conclusion: The SAS offered by the FNC, which includes education strategies and the identification and solving of barriers hindering the use of PAP devices, significantly increased the hours of use of the device and the % of days in which it was used more than 4 hours in the study population, in particular in men.