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Published on: December 6, 2016
Compliance with noninvasive home ventilation in children with obstructive sleep apnoea
Anna Maria Nathan1, Jenny Poh Lin Tang, Anne Goh
1Asthma, Lung, Sleep and Allergy Centre, Gleneagles Medical Centre, 6 Napier Road, Singapore 258499. jenny.tang.pl@gmail.com.
Insights
Compliance with noninvasive home ventilation for pediatric obstructive sleep apnea is low, with only 41.2% of children adhering to treatment. Female gender and asthma diagnosis were linked to better compliance.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Respiratory Care
Background:
- Obstructive sleep apnea (OSA) is a common condition in children.
- Noninvasive home ventilation is a key treatment for pediatric OSA.
- Understanding treatment compliance is crucial for effective management.
Purpose of the Study:
- To determine compliance rates with noninvasive home ventilation in children with OSA.
- To identify factors associated with treatment compliance in this population.
Main Methods:
- Retrospective review of 51 children prescribed noninvasive home ventilation for OSA.
- Compliance defined as use ≥ 4 days/week.
- Analysis of demographic, clinical, and treatment-related factors.
Main Results:
- Overall compliance was 41.2%.
- Female gender, presence of asthma, genetic syndromes, bi-level ventilation use, and social work funding were associated with compliance in univariate analysis.
- Logistic regression identified female gender and asthma as significant predictors of compliance.
Conclusions:
- Treatment compliance with noninvasive home ventilation in children with OSA is suboptimal.
- Female sex and asthma are positively associated with treatment adherence.
- Further research is needed to develop strategies for improving ventilation compliance in pediatric OSA.
Introduction:
This study aimed to determine compliance with noninvasive home ventilation in children with obstructive sleep apnoea and the factors affecting this compliance.
Methods:
We retrospectively reviewed 51 children who were prescribed noninvasive home ventilation for the management of obstructive sleep apnoea from 1 January 2000 until 31 May 2008. Noninvasive ventilation was started based on positive polysomnogram, i.e. obstructive apnoea hypopnea index ≥ 1/hr. Compliance was defined as the use of noninvasive ventilation ≥ 4 days/week.
Results:
Noninvasive home ventilation was started at a median age of 11.5 years. In all, 21 (41.2 %) children were reported to be compliant with treatment. Univariate analysis revealed that the female gender (p = 0.017), presence of asthma (p = 0.023), presence of genetic syndromes (p = 0.023), use of bi-level ventilation versus continuous positive airway pressure (p = 0.027), and funding from the social work department (p = 0.049) were associated with compliance with noninvasive home ventilation. Logistic regression revealed the presence of asthma (p = 0.008) and female gender (p = 0.047) to be significantly associated with compliance with treatment. However, factors such as counselling prior to initiation of treatment, severity of obstructive sleep apnoea before initiation of treatment, obesity, use of humidification, and polysomnogram indices were not found to be associated with treatment compliance.
Conclusion:
Only 41.2% of the children in this study were reported to be compliant with noninvasive home ventilation. The female gender and the presence of asthma were associated with treatment compliance. Future research focusing on effective methods to improve compliance with noninvasive home ventilation in children should be undertaken.
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