No3-4(5) 2022
Back to the issue
|
DOI 10.37219/2528-8253-2022-3-44 |
Dieieva YV
Low patient compliance to CPAP therapy as a new challenge in the management
of patients with obstructive sleep apnea syndrome: social, demographic
characteristics and the quality of life |
Dieeva Julia V.
MD, PhD, professor
Head of the department of Otorhinolaryngology
Bogomolets National Medical University, Kiev
E-mail: deyeva@bigmir.net
ORCID ID: 0000-0003-0552-1254
https://www.scopus.com/authid/detail.uri?authorId=55359076200 |
|
Abstract
Introduction: Obstructive sleep apnea syndrome (OSAS) is one of the
most common sleep disorders. According to various studies, the prevalence of
OSAS varies between 2-4% of men and 1-2% of women in the general population,
with more than 90% of cases among men and 80% of women being undiagnosed.
The "gold standard" for the treatment of OSAS is respiratory therapy using
CPAP. At the same time, the results of patients' compliance to CPAP are
controversial. Thus, the inability to use this method was noted by 45 to 80%
of patients, therefore it is important to study this group of patients, who
showed low compliance with CPAP.
Aim: to determine the social and demographic characteristics of the
group of patients with OSAS and low compliance with CPAP therapy, as well as
the impact of the disease on the quality of life of patients.
Materials and methods: The study included 80 patients with second
stage OSAS who had previously demonstrated low compliance with CPAP. Overall
demographic indicators were assessed, and patients were interviewed to
assess their quality of life using The Assessment of Quality of Life (AQoL)
instrument. Statist ical criteria included methods of descriptive statistics
(mean, mode, median, minimum and maximum value, variance). In
case of normal data distribution methods of parametric statistics were used,
and in case of uneven distribution – non-parametric criteria.
Results: The gender distribution in the group showed 67.5% of men and
32.5% of women. Average age was 39.35 (±9.49) years and 39.56 (±11.89)
years, respectively. The average value of the biomass index in men was 28.3
(±2.9), in women – 28.1 (±3.9). Only three people in the group reached
retirement age. The results of the survey of the quality of life showed a
significant reduction in the level of "Relationships with others", "Social
isolation", "Sleep" and "Anxiety and depression" (p <0.05).
Conclusions: The results of the study showed that the demographic
characteristics of the group of patients with OSAS with low compliance to
CPAP do not differ from the general patterns.
In addition, a questionnaire using The Assessment of Quality of Life (AQoL)
instrument showed a significant decrease in the quality of life of patients
due to worsening of social isolation and reduced psychological wellbeing. |
|
Keywords
obstructive sleep apnea syndrome, CPAP, compliance, quality of life. |
|
Reference
- Virk JS, Kotecha B. Otorhinolaryngological aspects of sleep-related
breathing disorders. J Thorac Dis. 2016;8:213-23. doi:
10.3978/j.issn.2072-1439.2016.01.39.
- Young T, Evans L, Finn L, Palta M. Estimation of the clinically
diagnosed proportion of sleep apnea syndrome in middle-aged men and
women. Sleep 1997;20:705-6. doi: 10.1093/sleep/20.9.705.
- Stradling JR, Crosby JH. Predictors and prevalence of obstructive
sleep apnoea and snoring in 1001 middle aged men. Thorax 1991;46:85-90.
doi: 10.1136/thx.46.2.85.
- He J, Kryger MH, Zorick FJ, et al. Mortality and apnea index in
obstructive sleep apnea. Experience in 385 male patients. Chest.
1988;94:9-14.
- Guilleminault C, Connolly SJ, Winkle RA. Cardiac arrhythmia and
conduction disturbances during sleep in 400 patients with sleep apnea
syndrome. Am J Cardiol 1983;52:490-4. doi: 10.1016/0002-9149(83)90013-9.
- George CF, Smiley A. Sleep apnea & automobile crashes. Sleep
1999;22:790-5.
- National Institute for Health and Clinical Excellence. Continuous
positive airway pressure for obstructive sleep apnoea/hypopnoea
syndrome. Available online: https://www.nice.org.uk/guidance/ta139/resources/continuous-posit
iveairway-pressure-for-obstructive-sleepapnoeahypopnoea-syndrome-374791501
- Monasterio C, Vidal S, Duran J, Ferrer M, Carmona C, Barbй F, et al.
Effectiveness of continuous positive airway pressure in mild sleep
apneahypopnea syndrome. Am J Respir Crit Care Med. 2001;164:939-43. doi:
10.1164/ajrccm.164.6.2008010.
- Bratton DJ, Stradling JR, Barbй F, Kohler M. Effect of CPAP on blood
pressure in patients with minimally symptomatic obstructive sleep apnoea:
a meta-analysis using individual patient data from four randomised
controlled trials. Thorax, 2014: 69(12): 1128-35. doi:
10.1136/thoraxjnl-2013-204993.
- Donovan LM, Boeder S, Malhotra A, Patel SR. New developments in the
use of positive airway pressure for obstructive sleep apnea. J. Thorac.
Dis. 2015:7(8):1323. doi: 10.3978/j.issn.2072-1439.2015.07.30.
- Lindberg E, Berne C, Elmasry A, Hedner J, Janson C. CPAP treatment
of a population-based sample – what are the benefits and the treatment
compliance? Sleep Med. 2006;7:553-60. doi: 10.1016/ j.sleep.2005.12.010.
- Denysenko R, Dikhtiaruk O, Naumenko O. [Influence of modified
uvulopalatopharyngoplasty on body weight and quality of night sleep in
patients with low compliance to CPAP therapy]. Otorhinolaryngology.
2020:3(4):73-8. doi 10.37219/2528-8253-2020-4-73. [Article in
Ukrainian].
- Boudewyns A, Marklund M, Hochban W. Alternatives for OSAHS
treatment: selection of patients for upper airway surgery and oral
appliances. Eur Respir J. 2007:16(106):132-145. doi: 10.1183/
09059180.00010604
- Hawthorne G, Richardson J, Osborne R. The Assessment of Quality of
Life (AQoL) instrument: a psychometric measure of health-related quality
of life. Qual Life Res. 1999:8(3):209-24. doi: 10.1023/a:1008815005736.
- Garvey JF, Pengo MF, Drakatos P, Kent BD. Epidemiological aspects of
obstructive sleep apnea. J. Thorac. Dis. 2015:7(5): 920. doi:
10.3978/j.issn.2072-1439.2015.04.52.
- Dutt N, Janmeja AK, Mohapatra PR, Singh AK. Quality of life
impairment in patients of obstructive sleep apnea and its relation with
the severity of disease. Lung India: Official Organ of Indian Chest
Society. 2013:30(4):289. doi: 10.4103/0970-2113.120603.
- Guyatt G. Insights and limitat ions from healthrelated
quality-of-life research. J Gen Intern Med. 1997:12(11):720-1. doi:
10.1046/j.1525-1497.1997.07149.x.
|
|