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Improving pediatric compliance with positive airway pressure therapy: the impact of behavioral intervention

Kristine L Koontz1, Keith J Slifer, Marilyn D Cataldo

  • 1The Kennedy Krieger Institute, Johns Hopkins University School of Medicine, USA. Kkoontzhca@cs.com

Sleep
|January 30, 2004
PubMed

Insights

Behavioral interventions significantly improved positive airway pressure (PAP) therapy compliance in children with obstructive sleep apnea. Most children receiving therapy showed increased PAP usage and satisfaction, highlighting the importance of behavior analysis.

Area of Science:

  • Pediatric Sleep Medicine
  • Behavioral Psychology
  • Rehabilitation Medicine

Background:

  • Obstructive sleep apnea (OSA) is a common condition in children, often treated with positive airway pressure (PAP) therapy.
  • Compliance with PAP therapy can be a significant challenge for pediatric patients and their families.
  • Behavioral interventions are increasingly recognized as crucial for improving adherence to medical treatments.

Purpose of the Study:

  • To describe behavioral interventions used to enhance PAP therapy compliance in children with OSA.
  • To assess physician and caregiver satisfaction with these behavioral interventions.
  • To present preliminary data on the effectiveness of these interventions on PAP usage.

Main Methods:

  • A retrospective, descriptive analysis was conducted at a pediatric psychology consultation service.
  • Twenty children (aged 1-17 years) with OSA and PAP non-compliance were included.
  • Participants were divided into groups receiving consultation and recommendations (CR+), consultation plus behavior therapy (BT), or recommendations without follow-up (CR-).

Main Results:

  • Prior to intervention, no children consistently used PAP. After behavioral intervention (CR+ and BT groups), 75% of children tolerated PAP with increased usage.
  • Children in the CR- group (no follow-up on behavior therapy) showed 0% increase in PAP usage.
  • Referring physicians and caregivers reported high satisfaction with the interventions in the CR+ and BT groups.

Conclusions:

  • Behavioral analysis and therapy are effective in improving PAP compliance in children with OSA.
  • These interventions can increase PAP usage, making its benefits accessible to more children.
  • The findings support the integration of behavioral strategies into OSA management for improved pediatric outcomes.
Abstract

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