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Paediatric CPAP in the digital age.

Anna Mulholland1, Rebecca Mihai1, Kirsten Ellis1

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Summary

Autotitrating CPAP (APAP) with remote monitoring did not improve adherence in children with obstructive sleep apnoea (OSA) compared to fixed pressure CPAP. However, a potential benefit was observed in younger children under 13 years old.

Keywords:
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Area of Science:

  • Pediatric Sleep Medicine
  • Respiratory Technology
  • Clinical Adherence Research

Background:

  • Continuous Positive Airway Pressure (CPAP) therapy adherence in pediatric obstructive sleep apnoea (OSA) remains a significant clinical challenge.
  • Technological advancements in CPAP devices offer potential solutions to improve patient compliance.

Purpose of the Study:

  • To compare adherence rates in children with OSA initiated on autotitrating CPAP (APAP) with remote monitoring versus those on fixed-pressure CPAP alone.
  • To evaluate the impact of newer CPAP technology on treatment adherence in a pediatric population.

Main Methods:

  • A retrospective study comparing two cohorts of children with OSA.
  • The APAP group (n=61) initiated between Feb 2017-Feb 2020 received APAP with remote monitoring for 90 days.
  • The CPAP group (n=unknown) initiated between Jul 2004-Sep 2008 received fixed-pressure CPAP alone.

Main Results:

  • No significant difference in adherence parameters was found between the APAP and CPAP groups.
  • The APAP group showed a trend towards higher usage (7.0 h/day) compared to the CPAP group (5.2 h/day), though not statistically significant (p=0.07).
  • Adherence was significantly associated with both age group and treatment type (p=0.006), with the youngest APAP group (<13 years) showing the highest usage.

Conclusions:

  • Autotitrating CPAP with remote monitoring did not demonstrate improved adherence over fixed-pressure CPAP in children with OSA.
  • A potential improvement in adherence may exist for children under 13 years using APAP.
  • Further large-scale randomized controlled trials are necessary to validate these findings.