scholarly journals Multidimensional Evaluation of Continuous Positive Airway Pressure (CPAP) Treatment for Sleep Apnea in Different Clusters of Couples

2020 ◽  
Vol 9 (6) ◽  
pp. 1658
Author(s):  
Monique Mendelson ◽  
Thibaut Gentina ◽  
Elodie Gentina ◽  
Renaud Tamisier ◽  
Jean-Louis Pépin ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Efficient Treatment ◽  
Cpap Adherence ◽  
Spousal Relationship ◽  
Spousal Relationships ◽  
Significant Difference ◽  
The Impact

Continuous positive airway pressure (CPAP) is the most efficient treatment of obstructive sleep apnea (OSA). Little is known about the impact of spousal relationship profiles on CPAP adherence. We aimed to identify clusters of couples of OSA patients, and their association with CPAP adherence 120 days after CPAP initiation. In a multicenter prospective study, OSA patients recently prescribed CPAP were enrolled with their spouses. Data about spousal relationships were collected at inclusion and at day 120. Latent class analysis was performed to determine homogeneous groups of spousal relationships. The 290 participants were predominantly males (77%), median age was 53 years and interquartile range (IQR) 46–62, median body mass index (BMI) was 32 kg/m2 (IQR: 28.6–35.9) and median apnea–hypopnea index: 43 events per hour (IQR: 33–58). Three couple clusters were identified: (1) older retired couples, (2) young working couples, and (3) mature active couples. Patients in the older retired couples cluster presented the highest CPAP adherence (p < 0.01) independently of initial complaints, OSA severity, and degree of improvement under CPAP. In a large cohort of OSA patients in whom clusters of couples were determined, there was a significant difference in CPAP adherence at day-120 after CPAP initiation.

scholarly journals Impact of the type of mask on the effectiveness of and adherence to continuous positive airway pressure treatment for obstructive sleep apnea

2014 ◽  
Vol 40 (6) ◽  
pp. 658-668 ◽  
Author(s):  
Rafaela Garcia Santos de Andrade ◽  
Vivien Schmeling Piccin ◽  
Juliana Araújo Nascimento ◽  
Fernanda Madeiro Leite Viana ◽  
Pedro Rodrigues Genta ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Treatment Effectiveness ◽  
Obstructive Sleep ◽  
Pubmed Database ◽  
Osa Treatment ◽  
The Impact

Continuous positive airway pressure (CPAP) is the gold standard for the treatment of obstructive sleep apnea (OSA). Although CPAP was originally applied with a nasal mask, various interfaces are currently available. This study reviews theoretical concepts and questions the premise that all types of interfaces produce similar results. We revised the evidence in the literature about the impact that the type of CPAP interface has on the effectiveness of and adherence to OSA treatment. We searched the PubMed database using the search terms "CPAP", "mask", and "obstructive sleep apnea". Although we identified 91 studies, only 12 described the impact of the type of CPAP interface on treatment effectiveness (n = 6) or adherence (n = 6). Despite conflicting results, we found no consistent evidence that nasal pillows and oral masks alter OSA treatment effectiveness or adherence. In contrast, most studies showed that oronasal masks are less effective and are more often associated with lower adherence and higher CPAP abandonment than are nasal masks. We concluded that oronasal masks can compromise CPAP OSA treatment adherence and effectiveness. Further studies are needed in order to understand the exact mechanisms involved in this effect.

Qualitative Assessment of the Effect of Continuous Positive Airway Pressure on the Nasal Cavity

2020 ◽  
Vol 34 (4) ◽  
pp. 487-493 ◽  
Author(s):  
Erin K. Reilly ◽  
Colin T. Huntley ◽  
Maurits S. Boon ◽  
Gregory Epps ◽  
Swar Vimawala ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Nasal Cavity ◽  
Skull Base ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Skull Base Surgery ◽  
Healthy Individuals ◽  
Significant Difference ◽  
The Impact ◽  
Cadaveric Model

Background For patients with obstructive sleep apnea (OSA), there is a lack of knowledge regarding the impact of continuous positive airway pressure (CPAP) on the nasal cavity. There is a significant need for evidence-based recommendations regarding the appropriate use of CPAP following endoscopic sinus and skull base surgery. Objective The goal of this study is to translate a previously developed cadaveric model for evaluating CPAP pressures in the sinonasal cavity by showing safety in vivo and quantifying the effect of positive pressurized air flow on the nasal cavity of healthy individuals where physiologic effects are at play. Methods A previously validated cadaveric model using intracranial sensor catheters has proved to be a reliable technique for measuring sinonasal pressures. These sensors were placed in the nasal cavity of 18 healthy individuals. Pressure within the nose was recorded at increasing levels of CPAP. Results Overall, nasal cavity pressure was on average 85% of delivered CPAP. The amount of pressure delivered to the nasal cavity increased as the CPAP increased. The percentage of CPAP delivered was 77% for 5 cmH2O and increased to 89% at 20 cmH2O. There was a significant difference in mean intranasal pressures between all the levels of CPAP except 5 cmH2O and 8 cmH2O ( P < .001). Conclusion On average, only 85% of the pressure delivered by CPAP is transmitted to the nasal cavity. Higher CPAP pressures delivered a greater percentage of pressurized air to the nasal cavity floor. Our results are comparable to the cadaver model, which demonstrated similar pressure delivery even in the absence of anatomic factors such as lung compliance, nasal secretions, and edema. This study demonstrates the safety of using sensors in the human nasal cavity. This technology can also be utilized to evaluate the resiliency of various repair techniques for endoscopic skull base surgery with CPAP administration.

scholarly journals Effectiveness of Continuous Positive Airway Pressure Versus Mandibular Advancement Device in Severe Obstructive Sleep Apnea Patients With Mandibular Retrognathia: A Prospective Clinical Trial

2020 ◽  
pp. 014556132096925
Author(s):  
Haichun Lai ◽  
Wei Huang ◽  
Wei Chen ◽  
Desheng Wang
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Mandibular Retrognathia

Aim: Some obstructive sleep apnea (OSA) patients may have mandibular retrognathia (ANB > 4.7° and SNB < 76.2°). Currently, there are no studies that have compared the effectiveness of continuous positive airway pressure (CPAP) versus mandibular advancement device (MAD) in severe OSA patients with mandibular retrognathia. We explored the efficacy of CPAP versus MAD for the treatment of severe OSA patients with mandibular retrognathia. Methods: A total of 105 patients were enrolled. Outcomes were assessed by using polysomnography, Epworth Sleepiness Scale (ESS), Snore Scale (SS), Self-rating Anxiety Scale (SAS), and compliance, before treatment and after 6 and 12 months of treatment. Results: Continuous positive airway pressure was superior to MAD in improving polysomnographic outcomes and SS score, but reported compliance was higher on MAD. There is no significant difference between the 2 treatments in terms of ESS score and SAS score. Obstructive sleep apnea patients with mandibular retrognathia showed greater improvement than those without mandibular retrognathia in terms of apnea-hypopnea index and oxygen desaturation index after MAD. Conclusion: Continuous positive airway pressure and MAD are both effective in treating severe OSA patients with mandibular retrognathia. Mandibular advancement device is a good alternative to CPAP in severe OSA patients with mandibular retrognathia. Mandibular advancement device is more effective in treating OSA patients with mandibular retrognathia than those without. Trial registration: ChiCTR2000032541.

559 Effect of Weekly Text Message Feedback on Continuous Positive Airway Pressure Adherence in Pediatric Obstructive Sleep Apnea

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A221-A221
Author(s):  
Christina Finch ◽  
Robert Bercovitch
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pilot Study ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Text Messages ◽  
Cpap Adherence ◽  
Obstructive Sleep ◽  
Automated Feedback

Abstract Introduction Continuous Positive Airway Pressure (CPAP) is an effective treatment for Obstructive Sleep Apnea (OSA) in children. However, adherence to CPAP therapy is often suboptimal. CPAP telemonitoring with automated feedback messaging has been shown to improved adherence in adults with OSA, but has not been widely studied as an intervention for children with OSA. This pilot study was conducted to investigate if feedback messaging could similarly improve CPAP adherence in children. Methods Pediatric OSA subjects (ages 11–17) with poor CPAP compliance or newly prescribed CPAP were selected from an outpatient Sleep Medicine clinic to receive weekly text messages with scripted feedback on CPAP adherence. Patients already meeting adherence goals were excluded from the study. Parental consent was obtained and participants were given the option to have text messages sent to parents or directly to the patient. Adherence was monitored over a four-month intervention period and compared to pre-intervention usage as a self-matched control. Total hours of use per month and numbers of days used per month were collected through daily remote CPAP monitoring. Average hours per use and average daily use per 30-day period were additional adherence measurements calculated. Data was analyzed using two-tailed paired T-tests with level of significance set at p&lt;0.05. Results There was no significant change in CPAP adherence (p&gt;.05) after initiation of weekly feedback messaging for the five patients included in the study. No participant, before or after intervention, met the Medicare definition of compliance (≥4hr nightly use for ≥ 70% of nights) and average adherence declined following intervention. Conclusion In a small pilot study, weekly feedback text messaging did not improve CPAP adherence in pediatric patients with OSA. This finding contrasts with larger studies in adult patients with OSA that have demonstrated improved CPAP adherence with automated feedback messaging. With the increasing use of telemedicine for CPAP follow-up, new strategies to successfully utilize this approach in the pediatric population may be needed. Support (if any) None.

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