Tovichien Prakarn, Kulbun Aunya, Udomittipong Kanokporn
Division of Pulmonology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Front Pediatr. 2022 Feb 11;10:841705. doi: 10.3389/fped.2022.841705. eCollection 2022.
The treatment outcomes of pediatric obstructive sleep apnea (OSA) are affected by positive airway pressure (PAP) therapy adherence, which may be affected by the type of device used. Continuous PAP (CPAP) devices deliver a continuous and fixed air pressure level, whereas automatic PAP (APAP) devices automatically adjust the pressure to meet changing needs during sleep. The adherence, tolerance and consistency of OSA-children's use of CPAP and APAP devices were compared.
One-year, observational cohort study.
Twenty-seven OSA-children were enrolled. Fourteen (52%) used CPAP, and 13 (48%) used APAP. The adherence, tolerance, and consistency of the PAP usage by the two groups were compared.
Overall, 11 of the 27 children (41%) showed good PAP adherence. The CPAP patients averaged 4.9 h of device usage on the days used, for 60% of days, with 6 of 14 (43%) demonstrating good adherence. In comparison, the APAP patients averaged 3.2 h for 55% of days, with 5 of 13 (38%) exhibiting good adherence. The 2 groups showed no differences in their adherence, tolerance, or consistency of device usage ( values, 0.816, 0.609, and 0.720, respectively). Although the adherence of both groups improved in the second 6 months, it was without statistical significance ( values, 0.400 and 0.724). Age, sex, baseline apnea-hypopnea index, comorbidities, prescribed period, device type, mask type, and caregiver education-level were not risk factors for poor PAP adherence.
No differences in the adherence, tolerance, or consistency of the children's use of CPAP and APAP were revealed in this small inhomogeneous cohort study with limited resources.
小儿阻塞性睡眠呼吸暂停（OSA）的治疗效果受气道正压（PAP）治疗依从性的影响，而这可能受所用设备类型的影响。持续气道正压通气（CPAP）设备提供持续且固定的气压水平，而自动气道正压通气（APAP）设备会自动调节压力以满足睡眠期间不断变化的需求。比较了OSA患儿使用CPAP和APAP设备的依从性、耐受性和一致性。
为期一年的观察性队列研究。
招募了27名OSA患儿。14名（52%）使用CPAP，13名（48%）使用APAP。比较了两组患儿PAP使用的依从性、耐受性和一致性。
总体而言，27名患儿中有11名（41%）显示出良好的PAP依从性。CPAP组患儿在使用设备的日子里平均使用4.9小时，占60%的天数，14名中有6名（43%）表现出良好的依从性。相比之下，APAP组患儿平均使用3.2小时，占55%的天数，13名中有5名（38%）表现出良好的依从性。两组在设备使用的依从性、耐受性或一致性方面无差异（P值分别为0.816、0.609和0.720）。尽管两组的依从性在第二个6个月有所改善，但无统计学意义（P值分别为0.400和0.724）。年龄、性别、基线呼吸暂停低通气指数、合并症、规定使用期、设备类型、面罩类型和照顾者教育水平均不是PAP依从性差的危险因素。
在这项资源有限的小型异质性队列研究中，未发现患儿使用CPAP和APAP在依从性、耐受性或一致性方面存在差异。
