Impact of the Novel Coronavirus Disease (COVID-19) on Treatment Adherence and Sleep Duration in Obstructive Sleep Apnea Patients Treated with Positive Airway Pressure

AbstractObjectiveTo examine the effect of COVID-19 on treatment adherence and self-reported sleep duration among patients with Obstructive Sleep Apnea (OSA) treated with positive airway pressure (PAP) therapy.MethodsRetrospective review of medical records of patients seen in Sleep and Circadian Clinic at Brigham Health during the immediate period of one month after the national lockdown was announced on March 15, 2020. Patients with OSA were included only if PAP adherence data was available in the 12-months prior and in the month after the lockdown. Patients with other sleep disorders and OSA patients without the adherence data were excluded.ResultsMean age was 63.5± 13.9 years, 55% of the participants were men, and mean BMI was 31.8 ± 7.9 kg/m2. Severe OSA was noted among 59.5% compared to 29.3% moderate, and 11.2% mild OSA. Increased number of patients reported insomnia after the lockdown (41% vs 48%, p= 0.02). Gender stratification noted worsening insomnia only among women. There was no significant difference in PAP adherence as measured by the hours of use, self-reported sleep duration or in the use of sleep medications.ConclusionPost COVID-19 lockdown had a negative impact on sleep as evidenced by increased reporting of insomnia particularly among women, but no impact on PAP adherence or self-reported sleep duration.

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Impact of the novel coronavirus disease on treatment adherence and sleep duration in patients with obstructive sleep apnea treated with positive airway pressure

Journal of Clinical Sleep Medicine ◽

10.5664/jcsm.8746 ◽

2020 ◽

Vol 16 (11) ◽

pp. 1917-1920 ◽

Cited By ~ 1

Author(s):

Salma Batool-Anwar ◽

Olabimpe S. Omobomi ◽

Stuart F. Quan

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Treatment Adherence ◽

Sleep Duration ◽

Airway Pressure ◽

Positive Airway Pressure ◽

The Novel ◽

Obstructive Sleep ◽

Novel Coronavirus

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Sleep Duration is increased but not Physical Activity in Somnolent Moderate to Severe Obstructive Sleep Apnea Patients Treated by Continuous Positive Airway Pressure

Journal of Sleep Disorders Treatment & Care ◽

10.4172/2325-9639.1000166 ◽

2015 ◽

Vol 04 (04) ◽

Author(s):

Bruyneel M ◽

C Sanida

Keyword(s):

Physical Activity ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Continuous Positive Airway Pressure ◽

Sleep Duration ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Severe Obstructive Sleep Apnea ◽

Obstructive Sleep

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Positive Airway Pressure Treatment Adherence in Adults with Obstructive Sleep Apnea: A Perspective on the Ever-evolving State of Science

Chonnam Research Institute of Nursing Science ◽

10.33527/nhi2019.24.2.75 ◽

2019 ◽

Vol 24 (2) ◽

pp. 75-88

Author(s):

Amy M. Sawyer

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Treatment Adherence ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Pressure Treatment ◽

Obstructive Sleep

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

Ear Nose & Throat Journal ◽

10.1177/0145561320969251 ◽

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.

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Adequate health literacy is associated with adherence to continuous positive airway pressure in adults with obstructive sleep apnea

SLEEP Advances ◽

10.1093/sleepadvances/zpab013 ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Claire M Ellender ◽

Sebastian Le Feuvre ◽

Mary Boyde ◽

Brett Duce ◽

Sara Winter ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Health Literacy ◽

Sleep Apnea ◽

Continuous Positive Airway Pressure ◽

Treatment Adherence ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Adequate Health Literacy ◽

Obstructive Sleep ◽

Inadequate Health Literacy

Abstract Study Objectives Obstructive sleep apnea (OSA) is a chronic disease with significant health implications and adequate adherence to continuous positive airway pressure (CPAP) is essential for effective treatment. In many chronic diseases, health literacy has been found to predict treatment adherence and outcomes. In this study, the aim was to determine the health literacy of a sleep clinic population and evaluate the association between health literacy and CPAP adherence. Methods A prospective cohort study was undertaken, recruiting 104 consecutive patients with a variety of sleep diagnoses. The Short Form Rapid Estimate of Adult Literacy in Medicine (REALM-SF), a validated questionnaire, was administered to measure health literacy. In a sub-group of 91 patients prescribed CPAP for OSA, CPAP usage was measured, with adequate usage defined as greater than 4 h/night CPAP therapy. Results Seventy-one percent of the sleep clinic cohort was found to have adequate health literacy, as measured by the REALM-SF. In those prescribed CPAP for OSA, inadequate health literacy was associated with a twofold increased risk for inadequate CPAP usage (adjusted odds ratio [OR] 2.9, 95% CI: 1.1 to 8.22, p = 0.045). There was a 1.7 h/night difference in median CPAP usage comparing those with adequate to inadequate health literacy (4.6 h vs. 6.3 h/night). Conclusions The majority of this sleep disorders cohort had adequate health literacy as measured by the REALM-SF questionnaire. However, inadequate health literacy appears to be an independent predictor of treatment adherence and may represent a modifiable risk factor of poor treatment outcomes in OSA.

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Olfactory Function in Patients With Obstructive Sleep Apnea Using Positive Airway Pressure

Ear Nose & Throat Journal ◽

10.1177/0145561319878949 ◽

2019 ◽

Vol 99 (4) ◽

pp. 239-244 ◽

Cited By ~ 1

Author(s):

Kerem Sami Kaya ◽

Meltem Akpınar ◽

Bilge Turk ◽

Nurullah Seyhun ◽

Mahmut Cankaya ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Olfactory Dysfunction ◽

Olfactory Function ◽

Future Research ◽

Apnea Hypopnea Index ◽

Obstructive Sleep ◽

Significant Difference

Previous studies reported that positive airway pressure (PAP) treatment may improve olfaction function in patients with obstructive sleep apnea (OSA) through various mechanisms. Olfactory function before and after PAP treatment is understudied regarding patient group at issue. The aim of this study is to investigate the contribution of PAP to olfactory function in patients with OSA. The study was conducted on 26 patients with OSA (10 females and 16 males, mean age 50.1 [9.3] years) who scheduled for PAP treatment. The Connecticut Chemosensory Clinical Research Center odor test was performed before and 4 months after PAP treatment. Patients were grouped (normal, anosmia, mild hyposmia, moderate hyposmia, and severe hyposmia) with respect to olfactory function by measuring odor test parameters, including threshold determination and identification. The odor test average scores of the patients after 4-month PAP treatment compared to pretreatment scores were increased and the difference was statistically significant ( P = .002). In the apnea hypopnea index groups, statistically significant difference was found in the threshold and discrimination values regarding before PAP treatment ( P = .038, P = .022, respectively). This study revealed that improvement in olfactory thresholds in patients with OSA receiving PAP treatment seems to improve olfactory dysfunction. This provides minimization of OSA consequences, including progressive upper airway inflammation, cognitive impairment, and associated olfactory dysfunction. Resolving the associations between olfactory function and PAP treatment is an important area for future research.

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Changes in Habitual Sleep Duration after Continuous Positive Airway Pressure for Obstructive Sleep Apnea

Annals of the American Thoracic Society ◽

10.1513/annalsats.201610-816oc ◽

2017 ◽

Vol 14 (6) ◽

pp. 986-993 ◽

Cited By ~ 3

Author(s):

Ryo Tachikawa ◽

Takuma Minami ◽

Takeshi Matsumoto ◽

Kimihiko Murase ◽

Kiminobu Tanizawa ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Continuous Positive Airway Pressure ◽

Sleep Duration ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Obstructive Sleep

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NCPAP for the treatment of obstructive sleep apnea

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x1989000200004 ◽

1989 ◽

Vol 47 (2) ◽

pp. 150-152 ◽

Cited By ~ 1

Author(s):

Ademir Baptista Silva ◽

Hélio Lemmi

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Continuous Positive Airway Pressure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Short Term ◽

Respiratory Parameters ◽

Obstructive Sleep ◽

Number Of Patients ◽

Term Basis

Nasal continuous positive airway pressure (NCPAP) represents a real advance in the management of obstructive sleep apnea (OSA). Our data show that except for awakenings, all sleep and respiratory parameters were significantly improved (p<0.05) in favor of the group treated with NCPAP. A main problem with NCPAP is the acceptance by the patient; it also may disturb the sleep, at least, on short term basis and, in a small number of patients, it does not correct the apneas. In our patients series, males responded better to NCPAP than females.

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The Current Status of Autotitrating Continuous Positive Airway Pressure Systems in the Management of Obstructive Sleep Apnea

Canadian Respiratory Journal ◽

10.1155/2005/870786 ◽

2005 ◽

Vol 12 (5) ◽

pp. 271-276 ◽

Cited By ~ 3

Author(s):

David Hailey ◽

Philip Jacobs ◽

Irvin Mayers ◽

Shaila Mensinkai

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Continuous Positive Airway Pressure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Term Treatment ◽

Current Status ◽

Short Term Treatment ◽

Obstructive Sleep ◽

Significant Difference

BACKGROUND: Autotitrating continuous positive airway pressure (APAP) devices have the potential to address some of the disadvantages of titration and treatment with conventional continuous positive airway pressure (CPAP). Information on the performance of APAP in clinical use is still comparatively limited.OBJECTIVE: To assess the status of APAP devices in the management of obstructive sleep apnea (OSA) by reviewing evidence of their efficacy, effectiveness and costs.METHODS: A systematic search of electronic databases and a review of selected comparative studies on the use of APAP in the diagnosis, titration and treatment of OSA was undertaken. Cost analysis using data applicable to the management of OSA in Edmonton, Alberta was performed.RESULTS: Thirty-three studies met the selection criteria: three on the use of APAP in diagnosing OSA; six on APAP for titration; 14 that considered short-term treatment outcomes; and 10 that addressed longer-term treatment of OSA. In most studies, patients suffering from cardiac, pulmonary and other medical conditions were excluded. Available data suggested some potential for the use of APAP in the diagnosis of OSA, but further validation is needed. In titration, estimated treatment pressures tended to be lower with APAP than with the manual titration of CPAP. Although lower treatment pressures were achieved with APAP, there was no significant difference in clinical outcome measures between APAP and CPAP. Estimates of costs suggested that APAP may provide savings in some scenarios.CONCLUSIONS: APAP shows promise in the management of OSA; however, given the exclusion of some categories of patients from trials of this technology, caution is still required in its use.

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