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Factors influencing continuous positive airway pressure adherence in elderly with obstructive sleep apnea
BACKGROUND: Continuous positive airway pressure (CPAP) is the most effective treatment for symptomatic obstructive sleep apnea (OSA). The identification of actual predictors of CPAP adherence in real-world practice is essential since it enhances more individualized management for the patient. CPAP a...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323596/ https://www.ncbi.nlm.nih.gov/pubmed/37426127 http://dx.doi.org/10.21037/jtd-23-8 |
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author | Tiyapun, Nantaporn Sunkonkit, Kanokkarn Chaiwong, Warawut Worasuthaneewan, Ratirat Theerakittikul, Theerakorn |
author_facet | Tiyapun, Nantaporn Sunkonkit, Kanokkarn Chaiwong, Warawut Worasuthaneewan, Ratirat Theerakittikul, Theerakorn |
author_sort | Tiyapun, Nantaporn |
collection | PubMed |
description | BACKGROUND: Continuous positive airway pressure (CPAP) is the most effective treatment for symptomatic obstructive sleep apnea (OSA). The identification of actual predictors of CPAP adherence in real-world practice is essential since it enhances more individualized management for the patient. CPAP acceptance and adherence in elderly patients with OSA have the same challenges but the conclusion remains unclear. Therefore, our aim was to explore the factors influencing the adherence of CPAP in elderly OSA patients. METHODS: The retrospective observational study was conducted from OSA patients’ computerized medical records at Sleep Disorders Center, Center of Medical Excellence, Chiang Mai University Hospital, Chiang Mai, Thailand between 2018 and 2020. Multivariable risk regression analyses were performed to evaluate the independent factors associated with CPAP non-acceptance and CPAP non-adherence. RESULTS: Of the 1,070 patients who underwent overnight polysomnography (PSG), 336 (31.4%) were elderly. Of 759 patients who accepted CPAP treatment, 221 (29.1%) were elderly, including 27 (12.2%) non-adherences, 139 (62.9%) adherences and 55 (24.8%) loss follow-up. Elderly patients with adverse attitudes toward CPAP use affected adherence to treatment [adjusted risk ratio (RR) =4.59, 95% CI: 1.79, 11.78, P=0.002]. Female was also associated with low CPAP adherence with adjusted RR =3.10 (95% CI: 1.07, 9.01), P=0.037. CONCLUSIONS: In our largest cohort to date, elderly OSA patients treated with CPAP over long-term follow-ups demonstrated that adherence rates were associated with personal life issues and adverse attitudes towards treatment as well as health problems. Female was also associated with low CPAP adherence. Therefore, in the elderly with OSA, the indication and treatment of CPAP should be customized individually, and if prescribed, regular monitoring to address noncompliance and tolerance should be considered. |
format | Online Article Text |
id | pubmed-10323596 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-103235962023-07-07 Factors influencing continuous positive airway pressure adherence in elderly with obstructive sleep apnea Tiyapun, Nantaporn Sunkonkit, Kanokkarn Chaiwong, Warawut Worasuthaneewan, Ratirat Theerakittikul, Theerakorn J Thorac Dis Original Article of Sleep Section BACKGROUND: Continuous positive airway pressure (CPAP) is the most effective treatment for symptomatic obstructive sleep apnea (OSA). The identification of actual predictors of CPAP adherence in real-world practice is essential since it enhances more individualized management for the patient. CPAP acceptance and adherence in elderly patients with OSA have the same challenges but the conclusion remains unclear. Therefore, our aim was to explore the factors influencing the adherence of CPAP in elderly OSA patients. METHODS: The retrospective observational study was conducted from OSA patients’ computerized medical records at Sleep Disorders Center, Center of Medical Excellence, Chiang Mai University Hospital, Chiang Mai, Thailand between 2018 and 2020. Multivariable risk regression analyses were performed to evaluate the independent factors associated with CPAP non-acceptance and CPAP non-adherence. RESULTS: Of the 1,070 patients who underwent overnight polysomnography (PSG), 336 (31.4%) were elderly. Of 759 patients who accepted CPAP treatment, 221 (29.1%) were elderly, including 27 (12.2%) non-adherences, 139 (62.9%) adherences and 55 (24.8%) loss follow-up. Elderly patients with adverse attitudes toward CPAP use affected adherence to treatment [adjusted risk ratio (RR) =4.59, 95% CI: 1.79, 11.78, P=0.002]. Female was also associated with low CPAP adherence with adjusted RR =3.10 (95% CI: 1.07, 9.01), P=0.037. CONCLUSIONS: In our largest cohort to date, elderly OSA patients treated with CPAP over long-term follow-ups demonstrated that adherence rates were associated with personal life issues and adverse attitudes towards treatment as well as health problems. Female was also associated with low CPAP adherence. Therefore, in the elderly with OSA, the indication and treatment of CPAP should be customized individually, and if prescribed, regular monitoring to address noncompliance and tolerance should be considered. AME Publishing Company 2023-05-30 2023-06-30 /pmc/articles/PMC10323596/ /pubmed/37426127 http://dx.doi.org/10.21037/jtd-23-8 Text en 2023 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article of Sleep Section Tiyapun, Nantaporn Sunkonkit, Kanokkarn Chaiwong, Warawut Worasuthaneewan, Ratirat Theerakittikul, Theerakorn Factors influencing continuous positive airway pressure adherence in elderly with obstructive sleep apnea |
title | Factors influencing continuous positive airway pressure adherence in elderly with obstructive sleep apnea |
title_full | Factors influencing continuous positive airway pressure adherence in elderly with obstructive sleep apnea |
title_fullStr | Factors influencing continuous positive airway pressure adherence in elderly with obstructive sleep apnea |
title_full_unstemmed | Factors influencing continuous positive airway pressure adherence in elderly with obstructive sleep apnea |
title_short | Factors influencing continuous positive airway pressure adherence in elderly with obstructive sleep apnea |
title_sort | factors influencing continuous positive airway pressure adherence in elderly with obstructive sleep apnea |
topic | Original Article of Sleep Section |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323596/ https://www.ncbi.nlm.nih.gov/pubmed/37426127 http://dx.doi.org/10.21037/jtd-23-8 |
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