Acoustic Reflection for Nasal Airway Measurement in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

Li, Hsueh Yu; Engleman, Heather M.; Hsu, Chia‐Yi; Izci, Bilgay; Vennelle, Marjorie; Cross, Melanie; Douglas, Neil J.

doi:10.1093/sleep/28.12.1554

Cited by 64 publications

(35 citation statements)

References 21 publications

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“…Several studies have identified a decrease in nasal volume, resulting in increased nasal resistance, influences CPAP use. (23–26) Acoustic rhinometry measures of nasal dimensions at baseline and after three months of CPAP use were examined by Li and associates. (23) CPAP use was significantly lower in those with a smaller nasal cross-sectional area, with CPAP adherence related to minimal cross-sectional area of the nasal cavity (r = 0.34; p = 0.008), mean area of the nasal cavity (r = 0.27; p = 0.04), and nasal cavity volume (r = 0.28; p = 0.03).…”

Section: What Factors Influence Cpap Adherence?mentioning

confidence: 99%

A systematic review of CPAP adherence across age groups: Clinical and empiric insights for developing CPAP adherence interventions

Sawyer

Gooneratne

Marcus

et al. 2011

Sleep Medicine Reviews

725

567

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Continuous positive airway pressure (CPAP) is a highly efficacious treatment for obstructive sleep apnea (OSA) but adherence to the treatment limits its overall effectiveness across all age groups of patients. Factors that influence adherence to CPAP include disease and patient characteristics, treatment titration procedures, technological device factors and side effects, and psychological and social factors. These influential factors have guided the development of interventions to promote CPAP adherence. Various intervention strategies have been described and include educational, technological, psychosocial, pharmacological, and multi-dimensional approaches. Though evidence to date has led to innovative strategies that address adherence in CPAP-treated children, adults, and older adults, significant opportunities exist to develop and test interventions that are clinically applicable, specific to subgroups of patients likely to demonstrate poor adherence, and address the multifactorial nature of CPAP adherence. The translation of CPAP adherence promotion interventions to clinical practice is imperative to improve health and functional outcomes in all persons with CPAP-treated OSA.

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Section: What Factors Influence Cpap Adherence?mentioning

confidence: 99%

A systematic review of CPAP adherence across age groups: Clinical and empiric insights for developing CPAP adherence interventions

Sawyer

Gooneratne

Marcus

et al. 2011

Sleep Medicine Reviews

725

567

View full text Add to dashboard Cite

show abstract

“…16 Moreover, long-term patient adherence is typically established within the fi rst week of CPAP therapy. [17][18][19] Certain factors have already been associated with poor adherence to CPAP therapy: lack of sleep specialist consultation prior to polysomnogram (PSG), 20,21 African American race, 20,22 low socioeconomic status, [23][24][25] reduced nasal airway caliber, 26 and mask leak, 27 to name a few. Social factors, such as living with another person, 28 spousal involvement, 29 and participation in educational support groups 30 are associated with improved CPAP adherence.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

A Brief Survey of Patients' First Impression after CPAP Titration Predicts Future CPAP Adherence: A Pilot Study

Balachandran

Yu²,

Wroblewski

et al. 2013

Journal of Clinical Sleep Medicine

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Background: CPAP adherence patterns are often established very early in the course of therapy. Our objective was to quantify patients' perception of CPAP therapy using a 6-item questionnaire administered in the morning following CPAP titration. We hypothesized that questionnaire responses would independently predict CPAP adherence during the fi rst 30 days of therapy. Methods: We retrospectively reviewed the CPAP perception questionnaires of 403 CPAP-naïve adults who underwent inlaboratory titration and who had daily CPAP adherence data available for the fi rst 30 days of therapy. Responses to the CPAP perception questionnaire were analyzed for their association with mean CPAP adherence and with changes in daily CPAP adherence over 30 days. Results: Patients were aged 52 ± 14 years, 53% were women, 54% were African American, the mean body mass index (BMI) was 36.3 ± 9.1 kg/m 2 , and most patients had moderate-severe OSA. Four of 6 items from the CPAP perception questionnaireregarding diffi culty tolerating CPAP, discomfort with CPAP pressure, likelihood of wearing CPAP, and perceived health benefi t-were signifi cantly correlated with mean 30-day CPAP adherence, and a composite score from these 4 questions was found to be internally consistent. Stepwise linear regression modeling demonstrated that 3 variables were signifi cant and independent predictors of reduced mean CPAP adherence: worse score on the 4-item questionnaire, African American race, and non-sleep specialist ordering polysomnogram and CPAP therapy. Furthermore, a worse score on the 4-item CPAP perception questionnaire was consistently associated with decreased mean daily CPAP adherence over the fi rst 30 days of therapy. Conclusions:In this pilot study, responses to a 4-item CPAP perception questionnaire administered to patients immediately following CPAP titration independently predicted mean CPAP adherence during the fi rst 30 days. Further prospective validation of this questionnaire in different patient populations is warranted. S C I E N T I F I C I N V E S T I G A T I O N ST he prevalence of obstructive sleep apnea (OSA) has been well documented 1 and is expected to increase as the prevalence of obesity increases.2 Untreated OSA is associated with not just increased cardiovascular 3 and metabolic risks, 4 but also with myriad comorbidities including decreased quality of life, 5 depressed mood, 6 decreased cognitive function, 7 increased risk of motor vehicle and occupational accidents, 8,9 and increased risk of pregnancy complications.10 Though continuous positive airway pressure (CPAP) therapy is highly effi cacious 11 and is associated with decreased cardiovascular morbidity and mortality 12,13 and metabolic morbidity, 14,15 treatment effectiveness depends largely on patient adherence, which is often suboptimal. 16 Moreover, long-term patient adherence is typically established within the fi rst week of CPAP therapy. 17-19Certain factors have already been associated with poor adherence to CPAP therapy: lack of sleep specialist consultation ...

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“…Li and associates [8 ] employed acoustic rhinometry to measure the internal dimensions of the airway. Measuring the nasal minimal cross-sectional area, mean area and volume, Li and associates found that CPAP use was significantly lower in those with a smaller nasal cross-sectional area (P ¼ 0.007).…”

Section: Patient Characteristicsmentioning

confidence: 99%

Adherence to positive airway pressure therapy

Weaver

2006

Current Opinion in Pulmonary Medicine

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Acoustic Reflection for Nasal Airway Measurement in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

Abstract: CPAP use in patients with smaller nasal passages was lower than in those with larger passages. Objective measurement of nasal dimension may be more reliable than subjective self-report of nasal symptoms in identifying patients with OSAHS who might struggle with CPAP therapy.

Cited by 64 publications

References 21 publications

A systematic review of CPAP adherence across age groups: Clinical and empiric insights for developing CPAP adherence interventions

A systematic review of CPAP adherence across age groups: Clinical and empiric insights for developing CPAP adherence interventions

A Brief Survey of Patients' First Impression after CPAP Titration Predicts Future CPAP Adherence: A Pilot Study

Adherence to positive airway pressure therapy

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