Obstructive sleep apnoea and adherence to continuous positive airway therapy among Australian women

Heraganahally, Subash S.; Zaw, Kyi Kyi; Tip, Sai; Jing, Xinlin; Mingi, Joy J; Howarth, Timothy; Roy, Anil K.; Falhammar, Henrik; Sajkov, Dimitar

doi:10.1111/imj.15076

Cited by 12 publications

(10 citation statements)

References 41 publications

(53 reference statements)

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“…Despite CPAP being established as a gold standard treatment modality for moderate to severe OSA, adherence to CPAP has consistently been noted to be low. 24 , 45 , 48–50 The simulation model in our study illustrates that PT may be beneficial in most patients with POSA, even among patients with moderate to severe OSA. The overall simulated PT impact in this group of patients, although lesser than that of CPAP, still resulted in two-thirds of patients demonstrating clinically significant improvement.…”

Section: Discussionmentioning

confidence: 65%

<p>Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects</p>

Garg¹,

Er²,

Howarth³

et al. 2020

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Purpose: To assess the prevalence of positional sleep apnea (POSA) and its predictors in patients diagnosed to have obstructive sleep apnea (OSA) in the regional and remote population of the Northern Territory of Australia over a two-year study period (2018 and 2019). Patients and Methods: Of the total 1463 adult patients who underwent a diagnostic polysomnography (PSG), 946 patients were eligible to be included in the study, of them, 810 consecutive patients with OSA (Apnea-Hypopnea Index (AHI) ≥ 5) who slept >4 h and had ≥30 min sleep in both supine and lateral positions were assessed. Patients were considered to have POSA if supine AHI to lateral AHI ratio ≥2. The likely comparative impact of use of continuous positive airway therapy (CPAP) or positional therapy (PT) on disease severity was evaluated using model simulation. Results: A total of 495/810 (61%) patients had POSA, the majority were males (68% vs 60%, p=0.013) and non-Indigenous Australians (93% vs 87%, p=0.004). POSA patients were younger (mean difference 2.23 years (95% CI 0.27, 4.19)), less obese (BMI mean difference 3.06 (95% CI 2.11, 4.01)), demonstrated less severe OSA (p < 0.001) and a greater proportion reported alcohol consumption (72% vs 62%, p=0.001) as compared to those with non-POSA. Using the simulation model, if patients with POSA use PT two-thirds (323/495, 65%) would obtain significant improvement of their OSA severity, with one in five (92/495, 19%) displaying complete resolution. Comparing this to simulated CPAP therapy, where the majority (444/495, 90%) will show significant improvement, and onethird (162/495, 33%) will display complete resolution. Conclusion: POSA needs to be routinely recognised and positional therapy integrated in practice especially in the remote regions and in the developing world when effective methods are in place to monitor positional therapy.

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Section: Discussionmentioning

confidence: 65%

<p>Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects</p>

Garg¹,

Er²,

Howarth³

et al. 2020

NSS

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“…Indigenous people have a higher burden of chronic health conditions, including cardiorespiratory disorders, giving rise to higher morbidity and mortality [33][34][35][36][37]. Understanding the different clinical manifestations [38][39][40] and appropriate interventions [41][42][43][44][45][46][47][48][49][50] will help in early diagnosis and management of chronic health conditions in the Indigenous population, for better health related outcomes. Varying manifestations of sex differences in PFTP's have been demonstrated in this study, both with and without underlying radiological evidence of CADs among an Indigenous Australian cohort.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease

et al. 2022

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Background Studies assessing normative values and sex differences in pulmonary function test parameters (PFTPs) among Indigenous populations are sparse. Methods PFTPs were compared between male and female Indigenous Australian adults with and without chest radiologically proven chronic airway diseases (CADs). Results 485 adults (56% were female) with no significant difference in age, body mass index or smoking status between sexes were included. Females displayed a higher prevalence of radiology without CADs compared to males (66 vs. 52%, respectively). Among patients without CADs, after adjustment for age, stature and smoking, males displayed significantly higher absolute values of Forced Vital Capacity (FVC) (mean difference, 0.41L (0.21,0.62), p<0.001) and Forced Expiratory Volume in one second (FEV1) (mean difference 0.27L (0.07,0.47), p<0.001), with no significant difference in FEV1/FVC ratio (mean difference -0.02 (-0.06, 0.02), p = 0.174). Male and female patients with radiologically proven CADs demonstrated lower FEV1/FVC values. However, compared to females, males showed significantly greater reductions in pre- [-0.53 (-0.74, -0.32) vs. -0.29 (-0.42, -0.16), p = 0.045] and post- [-0.51 (-0.72, -0.3) vs. -0.27 (-0.39, -0.14), p = 0.049] bronchodilator FEV1. Conclusions There are significant sex differences in the PFTPs among Indigenous Australians. Recognising these differences may be of value in the accurate diagnosis, management, monitoring and prognostication of CADs in this population.

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“…As such, it is plausible that the current study captured anywhere from 40% to 60% of current Indigenous COPD patients in the TEHS region. More recently, several aspects of respiratory health issues among Indigenous Australians from the TEHS region of the NT has been reported in the literature 19–24 28 32 35–40 52–66. Hence, this study could be considered as an important further step forward67 in addressing COPD disease awareness and knowledge in an Indigenous population.…”

Section: Discussionmentioning

confidence: 76%

COPD disease knowledge, self-awareness and reasons for hospital presentations among a predominately Indigenous Australian cohort: a study to explore preventable hospitalisation

et al. 2022

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BackgroundThe prevalence of chronic obstructive pulmonary disease (COPD) is higher among Indigenous Australians than that of non-Indigenous Australians. However, no studies have investigated COPD disease awareness and knowledge among Indigenous Australians. In this study, we assessed the COPD disease awareness among Indigenous and non-Indigenous patients in the Top End Health Service region of the Northern Territory of Australia.MethodsOf a total convenience sample of 100 adults, 86 patients consented to participate in this study over a 15-month period. A structured interview was conducted to identify participant’s level of knowledge about COPD, medications, self-management, healthcare interaction and utilisations.ResultsMost (69%) participants were Indigenous and men (52%). Indigenous patients were significantly younger (mean 56 vs 68 years p<0.001), with a higher proportion of remote residence and current smoking. COPD knowledge across the cohort was low, with 68% of Indigenous and 19% of non-Indigenous participants reporting they ‘know nothing/had never heard of COPD’. Most patients self-reported use of puffers/inhalers and were able to identify medication used; however, adherence to therapy was observed in only 18%. Shortness of breath was the most common symptom for hospital presentation (83%) and 69% of Indigenous patients reported seeking medical attention during an exacerbation. Self-management and COPD action plans were poorly implemented. A significant proportion (49%) reported ≥2 hospital admissions in the preceding 12 months. During exacerbation, although the majority of Indigenous patients were transferred to a tertiary centre from remote communities, patient’s preference was to be managed in their respective local communities.ConclusionsAwareness and understanding of COPD are low in this cohort on several domains. Tailored and culturally appropriate initiatives for both patients and health professionals alike are required to improve COPD disease management among Indigenous population. This will not only improve quality of life but also reduce recurrent hospitalisation, healthcare cost and utilisation.

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Obstructive sleep apnoea and adherence to continuous positive airway therapy among Australian women

Cited by 12 publications

References 41 publications

<p>Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects</p>

<p>Positional Sleep Apnea Among Regional and Remote Australian Population and Simulated Positional Treatment Effects</p>

Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease

COPD disease knowledge, self-awareness and reasons for hospital presentations among a predominately Indigenous Australian cohort: a study to explore preventable hospitalisation

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