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Any Effective Intervention to Improve CPAP Adherence in Children with Obstructive Sleep Apnea: A Systematic Review
Bundit Sawunyavisuth1, Chetta Ngamjarus2, Kittisak Sawanyawisuth3
1Department of Marketing, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen, Thailand.
Insights
Caregiver support and BiPAP therapy significantly improve continuous positive airway pressure (CPAP) adherence in children with obstructive sleep apnea (OSA). These interventions offer promising strategies for enhancing treatment effectiveness in pediatric OSA patients.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Health Services Research
Background:
- Obstructive sleep apnea (OSA) in children presents significant health challenges, mirroring adult complications.
- Continuous positive airway pressure (CPAP) is an effective treatment for pediatric OSA, but adherence rates remain low (around 50%).
- Improving CPAP adherence is crucial for managing pediatric OSA and preventing associated morbidities.
Purpose of the Study:
- To systematically review interventions aimed at enhancing CPAP adherence in pediatric patients diagnosed with OSA.
- To identify specific strategies that can improve treatment compliance and effectiveness in children using PAP therapy.
Main Methods:
- A systematic review was conducted, searching five databases for intervention studies on CPAP adherence in pediatric OSA.
- Search terms included 'OSA,' 'adherence,' 'compliance,' and 'CPAP.'
- Four studies involving interventions to improve CPAP compliance in children were included in the final analysis.
Main Results:
- Caregiver support was associated with significantly longer nightly CPAP use (86.60 minutes) and higher adherence (>4 hours/night by 18.10%).
- Patients receiving Bilevel Positive Airway Pressure (BPAP) therapy showed a significantly higher likelihood of good adherence (18.17 times) compared to those on CPAP.
- Two studies reported statistically significant differences favoring intervention groups.
Conclusions:
- Caregiver support and BPAP therapy are effective interventions for improving CPAP adherence in children with OSA.
- These findings highlight the importance of family involvement and alternative PAP modalities in pediatric OSA management.
- Further research is recommended to explore additional interventions and comparisons.
Abstract:
Obstructive sleep apnea (OSA) in children is leading to several consequences as reported in adults. A continuous positive airway pressure (CPAP) machine is one of the effective treatments in pediatric OSA. However, the CPAP adherence rate is approximately 50%. This study aimed to evaluate if any interventions that improve CPAP adherence in pediatric patients with OSA using a systematic review. We included intervention studies on CPAP adherence in pediatric patients with OSA regardless of machine types. Five databases were used for article searching. Search terms included OSA, adherence, compliance, and CPAP. The outcomes of this study were adherence rate and usage hours/minutes. The outcomes were compared between the intervention and comparator groups with descriptive statistics. There were 2931 articles from 5-database searching. There were 41 articles related with children. There were 7 articles conducted with any intervention on CPAP compliance. Of those, 4 studies included in the analysis. There were 3 significant differences between both groups in 2 studies. Those with caregiver support had significantly longer CPAP use/night by 86.60 minutes (95% CI 10.90, 162.30) and percentage of CPAP usage more than 4 hours/night by 18.10% (95% CI 3.87, 32.33) than those without caregiver support. Those who received BPAP therapy had higher chance of good PAP adherence than those who received CPAP by 18.17 times (95% CI 5.19, 63.70). Caregiver support and BPAP therapy significantly improved CPAP adherence in children with OSA. Further studies are required to add additional comparisons and also other interventions.
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