Continuous Positive Airway Pressure Therapy for Obstructive Sleep Apnea

Hevener, Bretton; Hevener, William

doi:10.1016/j.jsmc.2016.04.004

Cited by 14 publications

(7 citation statements)

References 12 publications

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“…5 Box plot showing statistical significant differences between study and control groups series. (Hevener and Hevener 2016) There may be selection bias because other therapeutic options have failed for these patients. We are conducting now a study with general population of patients with severe OSAHS.…”

Section: Discussionmentioning

confidence: 99%

New mHealth application software based on myofunctional therapy applied to sleep-disordered breathing in non-compliant subjects

O’Connor-Reina¹,

Plaza

Ignacio-Garcia³

et al. 2020

Sleep Science Practice

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Background: Myofunctional therapy (MT) is a therapeutic option with demonstrated efficacy for treating sleepdisordered breathing. We assessed the clinical application of a newly developed m-Health App, which aimed to allow patients with OSAHS (obstructive sleep apnea/hypopnea syndrome) to perform oropharyngeal exercises only by interacting with their smartphone without no other devices. Methods: We offered to treat the OSAHS of 20 patients with the App for 90 sessions. Inclusion criteria were adult patients diagnosed with OSAHS who rejected, or could not tolerate or afford treatment for their OSAHS with other modalities. The App was used by 15 patients, while 5 were noncompliant and then were used as a control group. Polygraphy was performed at the beginning of the study, and after 90 sessions in the App group or after 3 months in the control group. Data for adherence to treatment, sex, body mass index (BMI), age, O 2MIN (oxygen minimal saturation) and apnea-hypopnea index (AHI) were collected for both groups. Results: 15 (75%) patients showed adherence to the treatment as measured as performing the exercises daily 5 days a week. In patients who performed the exercises, AHI decreased from 25.78 ± 12.6 to 14.1 ± 7,7 (p = 0.002), Epworth changed from 18,2 ± 1,98 to 14,2 ± 7,7(p = 0,002) and (O 2MIN) changed from 84,87 ± 7.02 to 89,27 ± 3,77 (p = 0.0189). In the control group, there was no significant change. Conclusions: To our knowledge, this is the first study reported where a mHealth App based on MT could be by itself a therapeutic option in selected patients with OSAHS.

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Section: Discussionmentioning

confidence: 99%

New mHealth application software based on myofunctional therapy applied to sleep-disordered breathing in non-compliant subjects

O’Connor-Reina¹,

Plaza

Ignacio-Garcia³

et al. 2020

Sleep Science Practice

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“…Motivation and attitude are important factors to create the behavioral change needed to achieve adherent CPAP use [4]. The EBI could, supported by novel information technology-based systems for CPAP adherence [29], be used as a patient-centered tool to increase motivation and shared decision-making during the CPAP initiation process. A recent study found that CPAP practitioners perceived patients’ motivation and attitudes as the main determinants for CPAP adherence [9].…”

Section: Discussionmentioning

confidence: 99%

“…A total of 31% of the sample did not have CPAP adherence data at the 6-month follow-up which limited the possibility to assess EBIs predictive validity. Future studies could address this by using wirelessly transmitted CPAP data at follow-up [29]. We therefore consider our sample to be representative from a clinical perspective.…”

Section: Discussionmentioning

confidence: 99%

Psychometric properties of the Ethos Brief Index (EBI) using factorial structure and Rasch Analysis among patients with obstructive sleep apnea before and after CPAP treatment is initiated

et al. 2018

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Background Continuous positive airway treatment (CPAP) is the recommended treatment for patients with obstructive sleep apnea (OSA). Outcome measures often focus on clinical and/or self-rated variables related to the medical condition. However, a brief validated instrument focusing on the whole life situation (i.e., ethos) suitable for clinical practice is missing. The aim of this study was to investigate factorial structure, categorical functioning of the response scale, and differential item functioning across sub-populations of the Ethos Brief Index (EBI) among patients with obstructive sleep apnea (OSA) before and after initiation of continuous positive airway pressure (CPAP). Methods A prospective design, including 193 patients with OSA (68% men, 59.66 years, SD 11.51) from two CPAP clinics, was used. Clinical assessment and overnight respiratory polygraphy were used to diagnose patients. Questionnaires administered before and after 6 months of CPAP treatment included EBI, Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale, and global perceived health (initial item in SF-36). The validity and reliability of the EBI were investigated using Rasch and confirmatory factor analysis models. Measurement invariance, unidimensionality, and differential item functioning across gender groups, Apnea-Hypopnea Index, and ESS groups were assessed. Results The reliability of the EBI was confirmed using composite reliability and Cronbach’s alpha. The results supported unidimensionality of the EBI in confirmatory factor analysis and the Rasch model. No differential item functioning was found. A latent profile analysis yielded two profiles of patients with low ( n = 42) and high ( n = 151) ethos. Patients in the low ethos group were younger and had higher depression scores, lower perceived health, and higher body mass index. Conclusions The EBI is a valid tool with robust psychometric properties suitable for use among patients with OSA before and after treatment with CPAP is initiated. Future studies should focus on its predictive validity.

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“…The beginning of PAP therapy involves a process of behavioral change. Understanding the expectations and motivational stage of patients with OSA can help the sleep PT in their actions 91.…”

Section: Assessment Of Behaviormentioning

confidence: 99%

Practice recommendations for the role of physiotherapy in the management of sleep disorders: the 2022 Brazilian Sleep Association Guidelines

Frange¹,

Franco²,

Brasil³

et al. 2022

Sleep Sci

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This clinical guideline supported by the Brazilian Sleep Association comprises a brief history of the development of Brazilian sleep physiotherapy, outlines the role of the physiotherapist as part of a sleep health team, and describes the clinical guidelines in respect of the management of some sleep disorders by the physiotherapist (including sleep breathing disorders, i.e., obstructive sleep apnea, central sleep apnea, upper airway resistance syndrome, hypoventilation syndromes and overlap syndrome, and pediatric sleep breathing disorders; sleep bruxism; circadian rhythms disturbances; insomnia; and Willis-Ekbom disease/periodic limb movement disorder. This clinical practice guideline reflects the state of the art at the time of publication and will be reviewed and updated as new information becomes available.

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Continuous Positive Airway Pressure Therapy for Obstructive Sleep Apnea

Cited by 14 publications

References 12 publications

New mHealth application software based on myofunctional therapy applied to sleep-disordered breathing in non-compliant subjects

New mHealth application software based on myofunctional therapy applied to sleep-disordered breathing in non-compliant subjects

Psychometric properties of the Ethos Brief Index (EBI) using factorial structure and Rasch Analysis among patients with obstructive sleep apnea before and after CPAP treatment is initiated

Practice recommendations for the role of physiotherapy in the management of sleep disorders: the 2022 Brazilian Sleep Association Guidelines

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