Related Experiment Video
Updated: Mar 22, 2026
Using Continuous Data Tracking Technology to Study Exercise Adherence in Pulmonary Rehabilitation
Published on: November 8, 2013
Correlates of Pediatric CPAP Adherence
Stephen M M Hawkins1,2, Emily L Jensen3,4, Stacey L Simon1,2
1Department of Pediatric Pulmonology, University of Colorado School of Medicine, Aurora, CO.
Insights
Pediatric obstructive sleep apnea (OSA) patients show poor adherence to continuous positive airway pressure (CPAP) therapy. However, female patients and those with developmental delay demonstrated better CPAP adherence rates.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Medical Devices
Background:
- Obstructive sleep apnea (OSA) is a prevalent pediatric condition impacting upper airway function during sleep.
- Continuous positive airway pressure (CPAP) therapy is a primary treatment for pediatric OSA, aiming to reduce associated morbidity.
- Poor CPAP adherence remains a significant challenge in managing pediatric OSA, necessitating investigations into adherence factors.
Purpose of the Study:
- To investigate demographic, clinical, and comorbidity factors associated with CPAP adherence in pediatric patients with OSA.
- To identify predictors of successful CPAP use in children diagnosed with obstructive sleep apnea.
Main Methods:
- A retrospective chart review analyzed adherence data from pediatric CPAP patients over one year.
- CPAP adherence was defined as >70% nightly use and average usage ≥4 hours per night.
- Statistical analysis, including chi-squared tests, compared adherent and non-adherent groups.
Main Results:
- Nearly half of pediatric patients (49%) achieved CPAP adherence.
- Female sex (OR=2.41) and developmental delay (OR=2.55) were significantly associated with improved CPAP adherence.
- OSA severity, therapeutic pressure, and hypoxemia did not significantly influence CPAP adherence.
Conclusions:
- Pediatric CPAP adherence rates are suboptimal, highlighting a need for improved management strategies.
- Female sex and the presence of developmental delay are positive predictors of CPAP adherence in children.
- Further research is warranted to understand OSA pathophysiology and develop interventions to enhance pediatric CPAP adherence.
Study Objectives:
Obstructive sleep apnea (OSA) is a common pediatric condition characterized by recurrent partial or complete cessation of airflow during sleep, typically due to inadequate upper airway patency. Continuous positive airway pressure (CPAP) is a therapeutic option that reduces morbidity. Despite efforts to promote use, CPAP adherence is poor in both pediatric and adult populations. We sought to determine whether demographics, insurance status, OSA severity, therapeutic pressure, or comorbid conditions were associated with pediatric CPAP adherence.
Methods:
A retrospective review of adherence download data was performed on all pediatric patients with initiation or adjustment of CPAP treatment over a one-year period with documented in-laboratory CPAP titration. Patients were grouped as CPAP adherent or non-adherent, where adherence was defined as > 70% nightly use and average usage ≥ 4 hours per night. Differences between the groups were analyzed by χ(2) test.
Results:
Overall, nearly half of participants were CPAP adherent (49%, 69/140). Of the demographic data collected (age, ethnicity, sex, insurance status), only female sex was associated with better adherence (60.9% vs 39.5% of males adherent; odds ratio [OR] = 2.41, 95%CI = 1.20-4.85; p = 0.01). Severity of OSA (diagnostic apnea-hypopnea index [AHI] and degree of hypoxemia), therapeutic pressure, and residual AHI did not impact CPAP adherence (p > 0.05). Patients with developmental delay (DD) were more likely to be adherent with CPAP than those without a DD diagnosis (OR = 2.55, 95%CI = 1.27-5.13; p = 0.007). Female patients with trisomy 21 tended to be more adherent, but this did not reach significance or account for the overall increased adherence associated with female sex.
Conclusions:
Our study demonstrates that adherence to CPAP therapy is poor but suggests that female sex and developmental delay are associated with better adherence. These findings support efforts to understand the pathophysiology of and to develop adherence-promoting and alternative interventions for pediatric OSA.
Related Concept Videos
01:21Sleep Apnea
The condition is more prevalent among...
01:19Special considerations while measuring oxygen saturation
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is...
01:30Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes:
02:20Correlations
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...