Objective adherence to positive airway pressure therapy in an Australian paediatric cohort.
Sleep Breath
; 20(4): 1327-1336, 2016 Dec.
Article
em En
| MEDLINE
| ID: mdl-27591801
ABSTRACT
PURPOSE:
This study aimed to objectively measure adherence (compliance) and effectiveness of CPAP and BiLevel pressure support in an Australian paediatric population and determine factors associated with adherence outcomes.METHODS:
Data was collected as part of routine clinical care from 2011 to 2013. Adherence was recorded by downloads from the PAP device. "Adequate" adherence was defined as ≥4 h/night for 70 % of days used. Effectiveness of therapy was measured by polysomnography (PSG) pre- and post-PAP initiation. One year follow-up was undertaken to determine the long-term utilisation of PAP therapy.RESULTS:
Ninety-nine children were included (55 CPAP, 44 BiLevel). Mean age and BMI z-score were 6.9 ± 5.5 years and 0.1 ± 2.0 for CPAP and 9.8 ± 5.9 years and -0.5 ± 2.6 for BiLevel, respectively. At initial download, adequate adherence was observed in 75 % of CPAP and 91 % of BiLevel users. Mean hours of use (per night) for all nights used was 6.8 ± 2.8 and 9.3 ± 3.6 h, respectively. PSG demonstrated that CPAP use was associated with >60 % decrease in the obstructive apnoea hypopnoea index (OAHI, 19.0 ± 18.4 to 2.4 ± 3.1; p < 0.001). BiLevel use was associated with improved baseline SaO2 and TcCO2 (SaO2, 92.5 ± 5.4 % to 95.5 ± 2.9 %; p = 0.001 and reduction in TcCO2, 50.0 ± 10.9 mmHg to 44.8 ± 7.6 mmHg; p = 0.01). At follow-up, 22 (40 %) patients on CPAP and 26 (59 %) on BiLevel continued with therapy, and amongst these, adequate adherence was maintained in 76 % of CPAP and 80 % of Bilevel users.CONCLUSIONS:
In this Australian paediatric cohort (predominantly non-obese), adherence with BiLevel was greater than for CPAP. Over half of our population continue to utilise PAP therapy 1 year later, and amongst these cases, adequate adherence was maintained.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cooperação do Paciente
/
Apneia Obstrutiva do Sono
/
Pressão Positiva Contínua nas Vias Aéreas
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
País/Região como assunto:
Oceania
Idioma:
En
Revista:
Sleep Breath
Assunto da revista:
NEUROLOGIA
/
OTORRINOLARINGOLOGIA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Austrália