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Leelasittikul K, Pugongchai A, Tepwimonpetkun C, Saiphoklang N. Quality of Life, Mental Health, and CPAP Compliance in Thai Patients with Obstructive Sleep Apnea during COVID-19 Pandemic. SLEEP DISORDERS 2024; 2024:1373299. [PMID: 38695014 PMCID: PMC11060863 DOI: 10.1155/2024/1373299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/26/2024] [Accepted: 04/13/2024] [Indexed: 05/04/2024]
Abstract
Background This study is aimed at determining the quality of life, mental health, and adherence to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA) among Thai OSA patients during the coronavirus disease 2019 (COVID-19) pandemic as this data has been lacking. Methods A cross-sectional study was conducted at a university hospital between September 2021 and April 2022. OSA patients aged 18 years or older who required home CPAP treatment were included. Sleep Apnea Quality of Life Index (SAQLI) and Depression Anxiety Stress Scales-21 (DASS-21) were used to assess quality of life and mental health, respectively. Results A total of 142 participants (62% male) were included, with a mean age of 54.4 ± 14.7 years and a body mass index of 29.9 ± 6.8 kg/m2. Polysomnographic data showed a mean apnea-hypopnea index of 48.0 ± 32.4 events/hour and a mean lowest oxygen saturation of 79.2 ± 12.2%. Severe OSA was observed in 66.9%. CPAP compliance was reported in 50.7%. The SAQLI score was 2.32 ± 1.12. Depression, anxiety, and stress scores in DASS-21 were 2.89 ± 3.31, 3.94 ± 3.67, and 4.82 ± 4.00, respectively. Compared to the CPAP compliance group, the CPAP noncompliance group had higher daily activity scores in SAQLI (2.98 ± 1.25 vs. 2.45 ± 1.33, P = 0.015). Conclusions The quality of life for Thai OSA patients during the COVID-19 era was moderate degree. Poor CPAP compliance was significantly associated with limited daily activity. Enhancing CPAP compliance could improve the quality of life in these patients. This trial is registered with TCTR20211104004.
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Affiliation(s)
- Kanyada Leelasittikul
- Medical Diagnostics Unit, Thammasat University Hospital, Khlong Nueng, Pathum Thani, Thailand
- Sleep Center of Thammasat, Thammasat University Hospital, Khlong Nueng, Pathum Thani, Thailand
| | - Apiwat Pugongchai
- Medical Diagnostics Unit, Thammasat University Hospital, Khlong Nueng, Pathum Thani, Thailand
- Sleep Center of Thammasat, Thammasat University Hospital, Khlong Nueng, Pathum Thani, Thailand
| | - Chatkarin Tepwimonpetkun
- Sleep Center of Thammasat, Thammasat University Hospital, Khlong Nueng, Pathum Thani, Thailand
- Department of Internal Medicine, Faculty of Medicine, Thammasat University, Khlong Nueng, Pathum Thani, Thailand
| | - Narongkorn Saiphoklang
- Medical Diagnostics Unit, Thammasat University Hospital, Khlong Nueng, Pathum Thani, Thailand
- Sleep Center of Thammasat, Thammasat University Hospital, Khlong Nueng, Pathum Thani, Thailand
- Department of Internal Medicine, Faculty of Medicine, Thammasat University, Khlong Nueng, Pathum Thani, Thailand
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Brusić J, Grubešić A, Jarić F, Vučković T, Lekić A, Šustić A, Protić A. Use of CPAP Ventilation in Non-ICU Wards May Influence Outcomes in Patients with Severe Respiratory COVID-19. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:582. [PMID: 38674228 PMCID: PMC11052437 DOI: 10.3390/medicina60040582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: The COVID-19 disease has significantly burdened the healthcare system, including all units of severe patient treatment. Non-intensive care units were established to rationalize the capacity within the Intensive Care Unit (ICU) and to create a unit where patients with Acute Respiratory Distress Syndrome (ARDS) could be treated with non-invasive Continuous Positive Air Pressure (CPAP) outside the ICU. This unicentric retrospective study aimed to assess the efficacy of NIV Treatment in Patients of the fourth pandemic wave and how its application affects the frequency and mortality of ICU-treated patients at University Hospital Rijeka compared to earlier waves of the COVID-19 pandemic. Furthermore, the study showcases the effect of the Patient/Nurse ratio (P/N ratio) on overall mortality in the ICU. Materials and Methods: The study was conducted on two groups of patients with respiratory insufficiency in the second and third pandemic waves, treated in the COVID Respiratory Centre (CRC) (153 patients). We also reviewed a cohort of patients from the fourth pandemic wave who were initially hospitalized in a COVID-6 non-intensive unit from 1 October 2021 to 1 November 2022 (102 patients), and some of them escalated to CRC. Results: The introduction of the CPAP non-invasive ventilation method as a means of hypoxic respiratory failure treatment in non-intensive care units has decreased the strain, overall number of admissions, and CRC patient mortality. The overall fourth wave mortality was 29.4%, compared to the 58.2% overall mortality of the second and third waves. Conclusions: As a result, this has decreased CRC patient admissions and, by itself, overall mortality.
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Affiliation(s)
- Josip Brusić
- Department of Anesthesiology, Intensive Care and Pain Treatment, Clinical Hospital Center Rijeka, Krešimirova 42, 51 000 Rijeka, Croatia; (J.B.); (A.P.)
- Department of Nursing, Faculty of Health Studies, University of Rijeka, Viktora Cara Emina 5, 51000 Rijeka, Croatia
| | - Aron Grubešić
- Department of Hematology, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
- Department of Internal Medicine, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
| | - Filip Jarić
- Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia; (F.J.); (T.V.)
| | - Tin Vučković
- Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia; (F.J.); (T.V.)
| | - Andrica Lekić
- Department of Basic Medical Sciences, Faculty of Health Studies, University of Rijeka, Viktora Cara Emina 5, 51000 Rijeka, Croatia;
| | - Alan Šustić
- Department of Anesthesiology, Intensive Care and Pain Treatment, Clinical Hospital Center Rijeka, Krešimirova 42, 51 000 Rijeka, Croatia; (J.B.); (A.P.)
- Department of Nursing, Faculty of Health Studies, University of Rijeka, Viktora Cara Emina 5, 51000 Rijeka, Croatia
- Department of Anesthesiology, Reanimatology, Emergency and Intensive Medicine, Faculty of Medicine, University of Rijeka, Tome Strižića 3, 51000 Rijeka, Croatia
| | - Alen Protić
- Department of Anesthesiology, Intensive Care and Pain Treatment, Clinical Hospital Center Rijeka, Krešimirova 42, 51 000 Rijeka, Croatia; (J.B.); (A.P.)
- Department of Nursing, Faculty of Health Studies, University of Rijeka, Viktora Cara Emina 5, 51000 Rijeka, Croatia
- Department of Anesthesiology, Reanimatology, Emergency and Intensive Medicine, Faculty of Medicine, University of Rijeka, Tome Strižića 3, 51000 Rijeka, Croatia
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Bouloukaki I, Pataka A, Mauroudi E, Moniaki V, Fanaridis M, Schiza SE. Impact of the COVID-19 pandemic on positive airway pressure adherence and patients' perspectives in Greece: the role of telemedicine. J Clin Sleep Med 2023; 19:1743-1751. [PMID: 37218340 PMCID: PMC10545996 DOI: 10.5664/jcsm.10664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 05/24/2023]
Abstract
STUDY OBJECTIVES To analyze the impact of national lockdowns in Greece on positive airway pressure adherence, patients' perspectives regarding COVID-19 pandemic and the role of telemedicine. METHODS 872 obstructive sleep apnea patients from southern and 673 from northern Greece, under positive airway pressure treatment, were evaluated with adherence data available 12 months prior to and 3 months after the first and second lockdown. Telemedicine, locally available as part of a research protocol, was used for patient's follow-up in southern Greece and standard follow-up procedures were implemented in northern Greece. We analyzed the impact of COVID-19 lockdown on positive airway pressure adherence and patients' concerns regarding COVID-19 infection. RESULTS Significant difference was noted in positive airway pressure adherence as measured by the hours of use at 12 months prior to and at the 3 months after the first lockdown in southern (5.6 vs 6.6, P = .003) and northern Greece (5.3 vs 6.0, P = .03). The proportion of patients with optimal adherence (≥ 6 hours) increased by 18% (P = .004) in southern and by 9% (P = .20) in northern Greece after the first lockdown and remained steady after the second lockdown in both groups. In southern Greece, 23% of patients reported that they were concerned about getting COVID-19 due to obstructive sleep apnea diagnosis, while only 3% reported decreased sleep duration. Moreover, 9% were concerned that the presence of obstructive sleep apnea would make them more susceptible for worse outcome in case of COVID-19 infection. CONCLUSIONS Our results suggest that maintaining follow-up using telemedicine had a positive influence pointing out the potential role of digital health. CITATION Bouloukaki I, Pataka A, Mauroudi E, Moniaki V, Fanaridis M, Schiza SE. Impact of the COVID-19 pandemic on positive airway pressure adherence and patients' perspectives in Greece: the role of telemedicine. J Clin Sleep Med. 2023;19(10):1743-1751.
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Affiliation(s)
- Izolde Bouloukaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Athanasia Pataka
- Department of Respiratory Medicine, G Papanikolaou Hospital, Respiratory Failure Unit, Aristotle University of Thessaloniki, Greece
| | - Eleni Mauroudi
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Violeta Moniaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Michalis Fanaridis
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Sophia E. Schiza
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
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Mendelson M, Duval J, Bettega F, Tamisier R, Baillieul S, Bailly S, Pépin JL. The individual and societal price of non-adherence to continuous positive airway pressure, contributors and strategies for improvement. Expert Rev Respir Med 2023; 17:305-317. [PMID: 37045746 DOI: 10.1080/17476348.2023.2202853] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
INTRODUCTION Continuous positive airway pressure (CPAP) is the first line therapy for obstructive sleep apnea (OSA). CPAP is highly effective for improving symptoms and quality of life but the major issue is adherence, with up to 50% of OSA discontinuing CPAP in the first 3 years after CPAP initiation. AREAS COVERED We present the individual and societal cost of non-adherence to CPAP, factors associated with non-adherence to CPAP, as well as current strategies for improving adherence including telehealth, couples-based interventions and behavioral interventions. We also report on challenges and pitfalls for the visualization and analysis of CPAP remote monitoring platforms. EXPERT OPINION CPAP termination rates and adherence to therapy remain major issues despite technical improvements in CPAP devices. The individual and societal price of non-adherence to CPAP for OSA patients goes beyond excessive sleepiness and includes cardiovascular events, all-cause mortality, and increased health costs. Strategies for improving CPAP adherence should be individually tailored and aim to also improve lifestyle habits including physical activity and nutrition. Access to these strategies should be supported by refining visualization dashboards of CPAP remote monitoring platforms, and by disseminating telehealth and innovative analytics, including artificial intelligence.
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Affiliation(s)
- Monique Mendelson
- HP2 Laboratory, Inserm U1300, Grenoble Alps University, Grenoble, France
| | - Jeremy Duval
- HP2 Laboratory, Inserm U1300, Grenoble Alps University, Grenoble, France
- LVL Médical, 44 Quai Charles de Gaulle Lyon, France
| | - François Bettega
- HP2 Laboratory, Inserm U1300, Grenoble Alps University, Grenoble, France
| | - Renaud Tamisier
- HP2 Laboratory, Inserm U1300, Grenoble Alps University, Grenoble, France
| | | | - Sébastien Bailly
- HP2 Laboratory, Inserm U1300, Grenoble Alps University, Grenoble, France
| | - Jean-Louis Pépin
- HP2 Laboratory, Inserm U1300, Grenoble Alps University, Grenoble, France
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Jo S, Cho J. Impact of the COVID-19 pandemic on adherence to positive airway pressure treatment in patients with obstructive sleep apnea: systematic review and meta-analysis. Ther Adv Respir Dis 2023; 17:17534666231214040. [PMID: 38146255 PMCID: PMC10752124 DOI: 10.1177/17534666231214040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/19/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND The adverse effects of the COVID-19 pandemic on sleep have been well studied. However, whether the COVID-19 pandemic impacted positive airway pressure (PAP) adherence in patients with obstructive sleep apnea (OSA) remains unclear. OBJECTIVES To evaluate the impact of the COVID-19 pandemic on adherence to PAP therapy in patients with OSA. DESIGN A retrospective cohort study, systematic review, and meta-analysis. DATA SOURCES AND METHODS The retrospective study included adults with OSA who received PAP prescriptions within the year before and the year after the start date of COVID-19 social distancing (22 March 2020) in South Korea. The threshold of clinical significance for PAP adherence was defined as 0.5 h/day. We also searched for relevant studies published up to 15 January 2023 using the MEDLINE and Embase databases. We performed a random-effects meta-analysis of our findings with the identified studies regarding the standardized mean change (SMC) with a 95% CI of PAP adherence. RESULTS Our study included a total of 306 patients (mean age, 59.7 years; men, 73.5%). The average daily PAP usage was 5.10 ± 1.63 h before the COVID-19 pandemic and 4.79 ± 1.96 h during the pandemic (mean difference, -0.31 h/day; 95% CI, -0.46 to -0.15 h/day; p < 0.001 using paired t-test). After identifying 10 observational before-and-after studies through a systematic review, we conducted a meta-analysis that included our original data and showed that adherence to PAP treatment was not different before and during the COVID-19 pandemic (SMC, 0.01; 95% CI, -0.18 to 0.19; p = 0.952). CONCLUSION Although the COVID-19 pandemic had a statistically negative impact on adherence to PAP treatment in South Korea, the effect was not clinically relevant in patients with OSA. According to our meta-analysis, adherence to PAP treatment was not different before and during the COVID-19 pandemic in patients with OSA. TRIAL REGISTRATION PROSPERO database; No.: CRD42023414268; URL: https://www.crd.york.ac.uk/PROSPERO.
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Affiliation(s)
- Soomin Jo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Jaeyoung Cho
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2022; 128:248-330. [PMID: 36096911 DOI: 10.1016/j.prosdent.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2021 dental literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to coverage of this broad topical area. Specific subject areas addressed, in order of the appearance in this report, include COVID-19 and the dental profession (new); prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence daily dental treatment decisions with an emphasis on future trends in dentistry. With the tremendous volume of dentistry and related literature being published daily, this review cannot possibly be comprehensive. Rather, its purpose is to update interested readers and provide important resource material for those interested in pursuing greater details on their own. It remains our intent to assist colleagues in negotiating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the patients and dental problems they encounter.
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Johnson KG, Johnson DC. CPAP set-up by mail: we're not there yet. J Clin Sleep Med 2022; 18:1897-1898. [PMID: 35698726 PMCID: PMC9340598 DOI: 10.5664/jcsm.10150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Karin G Johnson
- Department of Neurology- Baystate Medical Center, University of Massachusetts Medical School-Baystate, Springfield, MA.,Institute for Healthcare Delivery and Population Science and Department of Medicine- University of Massachusetts Medical School - Baystate, Springfield, MA
| | - Douglas C Johnson
- Department of Medicine- Baystate Medical Center, University of Massachusetts Medical School-Baystate Springfield, MA
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Michalek-Zrabkowska M, Poreba R, Gac P, Frosztega W, Wojakowska A, Wieckiewicz M, Kanclerska J, Macek P, Wieckiewicz W, Mazur G, Martynowicz H. Telemetric Assessment of Continuous Positive Airways Pressure (CPAP) Effectiveness and Adherence in Obstructive Sleep Apnea during COVID-19 Pandemic. Biomedicines 2022; 10:biomedicines10051011. [PMID: 35625748 PMCID: PMC9138500 DOI: 10.3390/biomedicines10051011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/20/2022] [Accepted: 04/25/2022] [Indexed: 01/25/2023] Open
Abstract
Obstructive sleep apnea is the most common sleep-related breathing disorder. In the pandemic times of the new coronavirus SARS-CoV-2, CPAP (Continuous Positive Airway Pressure) therapy of obstructive sleep apnea became even more challenging. After the pandemic outbreak in March 2020, most CPAP treatment recommendations changed because of rising concerns about CPAP usage safety for patients and their families. Therefore, we examined the effectiveness of CPAP and adherence to the therapy of 149 adults with obstructive sleep apnea in the period of two years from 4 March 2019 to 3 March 2021 (before pandemic breakout and during the first year of pandemic). Data on CPAP parameters and adherence to therapy were obtained via a telemetric system. Together, our results demonstrated that the COVID-19 pandemic had no significant impact on CPAP therapy parameters and adherence in whole study group. However, detailed analysis acknowledged that some demographic and clinical features influenced CPAP therapy. The results showed that across subgroups of patients differentiated on the basis of age, gender, co-existing diabetes mellitus, or hypertension, the COVID-19 pandemic seemed to affect CPAP effectiveness. Our results provide a good starting point for discussion on CPAP therapy recommendations during pandemic times.
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Affiliation(s)
- Monika Michalek-Zrabkowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (R.P.); (W.F.); (A.W.); (J.K.); (P.M.); (G.M.); (H.M.)
| | - Rafal Poreba
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (R.P.); (W.F.); (A.W.); (J.K.); (P.M.); (G.M.); (H.M.)
| | - Pawel Gac
- Division of Environmental Health and Occupational Medicine, Department of Population Health, Wroclaw Medical University, 7 Mikulicza-Radeckiego St., 50-345 Wroclaw, Poland
- Correspondence: ; Tel.: +48-71-784-15-01
| | - Weronika Frosztega
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (R.P.); (W.F.); (A.W.); (J.K.); (P.M.); (G.M.); (H.M.)
| | - Anna Wojakowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (R.P.); (W.F.); (A.W.); (J.K.); (P.M.); (G.M.); (H.M.)
| | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland;
| | - Justyna Kanclerska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (R.P.); (W.F.); (A.W.); (J.K.); (P.M.); (G.M.); (H.M.)
| | - Piotr Macek
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (R.P.); (W.F.); (A.W.); (J.K.); (P.M.); (G.M.); (H.M.)
| | - Wlodzimierz Wieckiewicz
- Department of Prostodontics, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland;
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (R.P.); (W.F.); (A.W.); (J.K.); (P.M.); (G.M.); (H.M.)
| | - Helena Martynowicz
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (R.P.); (W.F.); (A.W.); (J.K.); (P.M.); (G.M.); (H.M.)
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Teague TT, Debian A, Kokonda M, Malhotra S, Arentson-Lantz E, Shaib F, Nowakowski S. Longitudinal Analysis Evaluating Self-Reported CPAP Use for OSA during the COVID-19 Pandemic. Brain Sci 2022; 12:brainsci12020131. [PMID: 35203895 PMCID: PMC8870344 DOI: 10.3390/brainsci12020131] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/08/2022] [Accepted: 01/14/2022] [Indexed: 11/27/2022] Open
Abstract
Continuous positive airway pressure therapy (CPAP) is a highly effective treatment for obstructive sleep apnea (OSA), but CPAP adherence remains suboptimal. The COVID-19 pandemic significantly altered sleep medicine services and aspects of daily living for sleep medicine patients, which may further compromise CPAP adherence. Sleep medicine patients were distributed an online survey at baseline and six months later (January–May 2021). Participants answered questions regarding CPAP use (any changes in CPAP use, sleep quality with CPAP use, CPAP use as advised, and changes in daily habits). Eighty-one adults completed the baseline survey, and 54 adults completed the follow-up survey. Twenty-seven participants reported a diagnosis of OSA and were prescribed CPAP (mean age 58 ± 18.2 years, 48% female, 67% Caucasian). Longitudinal analysis with chi-square association testing showed significant changes in CPAP use as advised and significant improvements in sleep quality with CPAP use when comparing the baseline to six-month follow-up survey. Additionally, logistic regression was performed to determine if pre-pandemic sleep study results (apnea-hypopnea index and respiratory disturbance index) predicted self-reported CPAP use during the pandemic, though no association was found. Throughout the pandemic, sleep medicine patients improved their CPAP use as advised and reported significant improvements in sleep quality with CPAP use.
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Affiliation(s)
- Taylor Torrence Teague
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA; (T.T.T.); (A.D.); (M.K.); (S.M.); (F.S.)
- Department of Pediatrics, Texas Children’s Hospital, Houston, TX 77030, USA
| | - Ahmad Debian
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA; (T.T.T.); (A.D.); (M.K.); (S.M.); (F.S.)
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veteran Affairs Medical Center, Houston, TX 77021, USA
| | - Manasa Kokonda
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA; (T.T.T.); (A.D.); (M.K.); (S.M.); (F.S.)
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veteran Affairs Medical Center, Houston, TX 77021, USA
| | - Sonal Malhotra
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA; (T.T.T.); (A.D.); (M.K.); (S.M.); (F.S.)
- Department of Pediatrics, Texas Children’s Hospital, Houston, TX 77030, USA
| | - Emily Arentson-Lantz
- Department of Nutrition & Metabolism, University of Texas Medical Branch, Galveston, TX 77555, USA;
| | - Fidaa Shaib
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA; (T.T.T.); (A.D.); (M.K.); (S.M.); (F.S.)
| | - Sara Nowakowski
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA; (T.T.T.); (A.D.); (M.K.); (S.M.); (F.S.)
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veteran Affairs Medical Center, Houston, TX 77021, USA
- Correspondence: ; Tel.: +1-(409)-539-0230
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Sunkonkit K, Selvadurai S, Voutsas G, Benzon D, Baker A, Trinh M, Narang I. To Wear or Not Wear the Mask: Decline in Positive Airway Pressure Usage in Children with Sleep Disordered Breathing During the COVID-19 Pandemic. Nat Sci Sleep 2022; 14:621-633. [PMID: 35431590 PMCID: PMC9012305 DOI: 10.2147/nss.s348978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/25/2022] [Indexed: 12/04/2022] Open
Abstract
PURPOSE Positive airway pressure (PAP) therapy is an effective treatment prescribed to children with sleep disordered breathing (SDB); however, PAP adherence remains challenging. Given that COVID-19 pandemic continues to impact sleep and daily life, the aim of this study was to evaluate longitudinal trajectory of PAP usage in children during the COVID-19 pandemic. PATIENTS AND METHODS This was a retrospective study. Children aged 1-18 years with SDB prescribed PAP at The Hospital for Sick Children (Toronto, Canada) were evaluated for PAP adherence. Demographics, medical history and PAP adherence data during four consecutive 3-month time periods from December 2019 to December 2020 were collected. These four time periods included i) prior to COVID-19 lockdown, ii) during the first three months of lockdown, iii) summer and iv) return to school period. Percentage of days where PAP was used for ≥4 hours and average nightly usage of PAP were primary outcomes. RESULTS A total of 149 children (61.7% male, mean (±SD) age=12.8 ± 4.1 years, BMI (±SD) z-score=1.45±1.43) were enrolled. Compared to prior to lockdown, the median (IQR) of percentage of PAP usage ≥4 hours and average nightly usage of PAP declined significantly during the summer and return to school periods (p<0.001 for all). By the end of the return to school period, only 69/149 (46%) showed sustained PAP usage and 80/149 (54%) had decreased PAP usage. Obesity was a risk factor for a decline in PAP usage after returning to school (β=-15.36, p=0.03). CONCLUSION Compared to COVID-19 pre-pandemic PAP usage, there was a significant decline in PAP usage across COVID-19 pandemic. There is critical under usage of PAP in children diagnosed with SDB, resulting in an urgent need to address barriers to mitigate poor adherence to PAP long-term. Targeted strategies are required to optimize PAP adherence in children with SDB.
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Affiliation(s)
- Kanokkarn Sunkonkit
- Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada.,Division of Pulmonary and Critical Care, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sarah Selvadurai
- Translational Medicine, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Giorge Voutsas
- Translational Medicine, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - David Benzon
- Translational Medicine, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Adele Baker
- Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Melissa Trinh
- Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Indra Narang
- Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada.,Translational Medicine, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Genzor S, Prasko J, Mizera J, Jakubec P, Sova M, Vanek J, Šurinová N, Langova K. Risk of Severe COVID-19 in Non-Adherent OSA Patients. Patient Prefer Adherence 2022; 16:3069-3079. [PMID: 36387050 PMCID: PMC9657257 DOI: 10.2147/ppa.s387657] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with obstructive sleep apnoea (OSA) are at increased risk of severe course of COVID-19. Vaccination remains to be the most effective prevention of complicated courses of infection. The best contemporary conservative treatment of OSA is continuous positive airway pressure (CPAP) therapy. PURPOSE To compare vaccination acceptance and outcomes of COVID-19 infection between OSA patients adhering to the CPAP therapy and those who rejected CPAP and surgical therapy. PATIENTS AND METHODS Subjects were divided into two groups: group A (N = 167) were individuals with sufficient CPAP adherence (more than 4 hours per night on average) over the last 10 years. Group B (N = 106) were individuals who did not use the CPAP therapy at all and had no indications to surgical therapy. RESULTS Three patients in group B died, and one had a severe course of COVID-19. None of the patients in group A died or experienced a severe course of COVID-19. Group A had a significantly higher proportion of males (77.8% compared to 66% in group B) and all parameters of OSA severity. The vaccination status was similar among both groups, with a complete triple dose vaccination rate of 69.5% and 67.9% in groups A and B, respectively. CONCLUSION The results show that the patients with OSA adherent to CPAP therapy were less likely to experience a severe course of COVID-19 or death than the OSA patients non-compliant with therapy, despite the former group having more severe OSA. This result underlines the importance of adherence to CPAP therapy in OSA.
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Affiliation(s)
- Samuel Genzor
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, OlomoucCzech Republic
| | - Jan Prasko
- Department of Psychiatry, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, OlomoucCzech Republic
- Institute for Postgraduate Education in Health Care, PragueCzech Republic
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, NitraThe Slovak Republic
- Correspondence: Jan Prasko, Department of Psychiatry, Faculty of Medicine and Dentistry, University Hospital Olomouc, I. P. Pavlova 6, Olomouc, 775 20, Czech Republic, Email
| | - Jan Mizera
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, OlomoucCzech Republic
| | - Petr Jakubec
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, OlomoucCzech Republic
| | - Milan Sova
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, OlomoucCzech Republic
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Masaryk University Brno and University Hospital Brno, BrnoCzech Republic
| | - Jakub Vanek
- Department of Psychiatry, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, OlomoucCzech Republic
| | | | - Katerina Langova
- Department of Biophysics, Palacky University Olomouc, OlomoucCzech Republic
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