Caregiver support and positive airway pressure therapy adherence among adolescents with obstructive sleep apnea

Parmar, Arpita; Messiha, Sandra; Baker, Adele; Zweerink, Allison; Toulany, Alène; Narang, Indra

doi:10.1093/pch/pxz107

Cited by 9 publications

(7 citation statements)

References 33 publications

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“…The proportion of female subjects in the broader studies is also similar to those studies focused on DS [39% (95% CI 35–44) vs. 44% (33–47%)]. Twelve of these studies included only the number of children with DS using LT-NIV so were not analyzed further ( 30 – 41 ).…”

Section: Resultsmentioning

confidence: 56%

Long-Term Non-invasive Ventilation in Children With Down Syndrome: A Systematic Review

et al. 2022

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ContextChildren with Down syndrome are at risk for obstructive sleep apnea, which may not be resolved by adenotonsillecotmy, as well as other respiratory disorders that may impact breathing during sleep. Long-term non-invasive ventilation, including continuous and bilevel positive airway pressure delivery, is an alternate treatment strategy.ObjectiveTo assess the use and outcomes of long-term non-invasive ventilation in children with Down syndrome including comparison to other children using long-term non-invasive ventilation.Data SourcesThe search strategy for the scoping review used Medical Subject Headings (MeSH) and free-text terms for “child” and “non-invasive ventilation.” MEDLINE (Ovid), Embase (Ovid), CINAHL (Ebsco), Cochrane Library (Wiley), and PubMed databases were searched (1990-2021).Study SelectionThe scoping review results were searched to identify studies including data on at least three children with Down Syndrome using long-term non-invasive ventilation.Data ExtractionStudy characteristics, subject characteristics, technology type, and outcome measurements were extracted.ResultsA total of 28 articles included 543 children with Down syndrome using long-term non-invasive ventilation. Children with Down syndrome accounted for 18% of children using long-term non-invasive ventilation. Data on efficacy, feasibility, and adherence in children with Down syndrome are comparable to other children. Children with Down syndrome may have greater difficulty initiating long-term non-invasive ventilation, longer time to establish use, and a higher rate of inability to establish use. Outcome data is limited but suggest favorable impact on cardiac function and attention.LimitationsArticles related to long-term non-invasive ventilation use in adolescents and young adults may have been excluded.ConclusionsChildren with Down syndrome make up a significant portion of the population of children using long-term non-invasive ventilation. While there is more limited data available with respect to the use and outcomes for children with Down syndrome compared to the other children, long-term non-invasive ventilation is an effective and well-tolerated therapy with no clear differences in the use or outcomes for children with Down syndrome. Additional work is needed to understand potential challenges around establishing long-term non-invasive ventilation use in children with Down syndrome.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=206533, identifier: CRD206533.

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Section: Resultsmentioning

confidence: 56%

Long-Term Non-invasive Ventilation in Children With Down Syndrome: A Systematic Review

et al. 2022

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“…Regarding outcomes between the intervention and comparator groups (Table 2 and Figures 2-9), 3 studies reported on average PAP used/night and adherence rate. [13][14][15] Among the outcomes, there were 3 significant differences between both groups in 2 studies as shown in Figures 2 to 4. 14,15 Those with caregiver support had significantly longer CPAP use/night by 86.60 minutes (95% CI 10.90, 162.30) and percentage of CPAP usage more than 4 hours/night by 18.10% (95% CI 3.87, 32.33) than those without caregiver support (Figures 2 and 3).…”

Section: Resultsmentioning

confidence: 94%

“…[13][14][15] Among the outcomes, there were 3 significant differences between both groups in 2 studies as shown in Figures 2 to 4. 14,15 Those with caregiver support had significantly longer CPAP use/night by 86.60 minutes (95% CI 10.90, 162.30) and percentage of CPAP usage more than 4 hours/night by 18.10% (95% CI 3.87, 32.33) than those without caregiver support (Figures 2 and 3). Those who received BPAP therapy had higher chance of good PAP adherence than those who received CPAP by 18.17 times (95% CI 5.19, 63.70) as shown in Figure 4.…”

Section: Resultsmentioning

confidence: 94%

“…There 4 articles published from 2008 to 2020 and conducted in 4 countries: Mexico, USA, Australia, and Canada ( Table 1 ). 9 , 13 - 15 One study was a randomized controlled trial, 9 while others were retrospective (2 articles) and cross-sectional study (1 article). Adherence data were objectively evaluated by download data from the PAP machine in all 4 articles with the longest follow up of 1 year.…”

Section: Resultsmentioning

confidence: 99%

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Any Effective Intervention to Improve CPAP Adherence in Children with Obstructive Sleep Apnea: A Systematic Review

Sawunyavisuth

Ngamjarus

Sawanyawisuth

2021

Global Pediatric Health

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Obstructive sleep apnea (OSA) in children is leading to several consequences as reported in adults. A continuous positive airway pressure (CPAP) machine is one of the effective treatments in pediatric OSA. However, the CPAP adherence rate is approximately 50%. This study aimed to evaluate if any interventions that improve CPAP adherence in pediatric patients with OSA using a systematic review. We included intervention studies on CPAP adherence in pediatric patients with OSA regardless of machine types. Five databases were used for article searching. Search terms included OSA, adherence, compliance, and CPAP. The outcomes of this study were adherence rate and usage hours/minutes. The outcomes were compared between the intervention and comparator groups with descriptive statistics. There were 2931 articles from 5-database searching. There were 41 articles related with children. There were 7 articles conducted with any intervention on CPAP compliance. Of those, 4 studies included in the analysis. There were 3 significant differences between both groups in 2 studies. Those with caregiver support had significantly longer CPAP use/night by 86.60 minutes (95% CI 10.90, 162.30) and percentage of CPAP usage more than 4 hours/night by 18.10% (95% CI 3.87, 32.33) than those without caregiver support. Those who received BPAP therapy had higher chance of good PAP adherence than those who received CPAP by 18.17 times (95% CI 5.19, 63.70). Caregiver support and BPAP therapy significantly improved CPAP adherence in children with OSA. Further studies are required to add additional comparisons and also other interventions.

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“…Patient family dynamics and demographics, rather than apnea severity, play a role in facilitating PAP adherence. Children with parents who take a proactive role in encouraging PAP adherence seemed to have increased PAP adherence, even among adolescents [54][55][56][57]. Reminders to use PAP as well as an authoritative style were all associated with increased PAP adherence, even among adolescents [54,58].…”

Section: Positive Airway Pressure Adherencementioning

confidence: 97%

Positive Airway Pressure Therapy for Pediatric Obstructive Sleep Apnea

Hady

Okorie

2021

Children

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Pediatric obstructive sleep apnea syndrome (OSAS) is a disorder of breathing during sleep, characterized by intermittent or prolonged upper airway obstruction that can disrupt normal ventilation and/or sleep patterns. It can affect an estimated 2–4% of children worldwide. Untreated OSAS can have far reaching consequences on a child’s health, including low mood and concentration as well as metabolic derangements and pulmonary vascular disease. Most children are treated with surgical intervention (e.g., first-line therapy, adenotonsillectomy); however, for those for whom surgery is not indicated or desired, or for those with postoperative residual OSAS, positive airway pressure (PAP) therapy is often employed. PAP therapy can be used to relieve upper airway obstruction as well as aid in ventilation. PAP therapy is effective in treatment of OSAS in children and adults, although with pediatric patients, additional considerations and limitations exist. Active management and care for various considerations important to pediatric patients with OSAS can allow PAP to be an effective and safe therapy in this population.

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Caregiver support and positive airway pressure therapy adherence among adolescents with obstructive sleep apnea

Cited by 9 publications

References 33 publications

Long-Term Non-invasive Ventilation in Children With Down Syndrome: A Systematic Review

Long-Term Non-invasive Ventilation in Children With Down Syndrome: A Systematic Review

Any Effective Intervention to Improve CPAP Adherence in Children with Obstructive Sleep Apnea: A Systematic Review

Positive Airway Pressure Therapy for Pediatric Obstructive Sleep Apnea

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