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CPAP Adherence Assessment and Therapeutic Strategies
Obstructive Sleep Apnea is considered the most prevalent Sleep Respiratory Disorder, affecting 1/3 of the world's population to some degree. Considered the “Gold Standard”, CPAP therapy is effective in controlling moderate and severe OSAS. However, studies have shown that some CPAP users doesn’t maintain satisfactory medium and long-term therapeutic adherence. Therefore, it is necessary to establish strategies that improve this adherence.
To analyze CPAP therapeutic adherence after two years of adaptation; to suggest therapeutic strategies for the CPAP adaptation process based on clinical practice.
Quantitative documentary research based on the collection and analysis of statistical data extracted from the reports provided by CPAP devices. Consultations were performed in a physiotherapy office, in Belém / PA, from January 2016 to July 2019. A sample of 32 patients (M: 19 and F: 13) aged 38 to 87 years old, previously submitted to type 1 PSG with moderate or serious AHI. All patients underwent the 4-week adaptation protocol, with 1 consultation and 3 returns. The analysis considered the % total use and % > 4h, both within the last six months after two years of treatment initiation. Patients used equipment with similar respiratory comfort features.
The average percentages of CPAP days of use and days of use >4h were 81% (M: 80%; F: 82%) and 66% (M: 65%; F: 68%), respectively. Patients with moderate AHI (n = 8) had a total% use of 72% and a %>4h of 56%. Patients with severe AHI (n = 24) had a total% use of 84% and %>4h of 70%. For patients up to 65 years (n = 19) the total% use was 78% and %>4h of 64%. For patients over 65 years (n = 13) the total% use was 85% and %>4h of 70%.
The following aspects are considered fundamental for better engagement and adherence to PAP: (1) cognitive behavioral (management of the emotional aspects involved); (2) educational (sleep hygiene and understanding of the health-disease process); (3) technicians (gradual and customized adjustments of ventilatory parameters); (4) availability of interfaces; (5) weekly feedbacks during the adaptation period and half-yearly in the first two years.
adaptation; sleep apnea; CPAP; adherence
Amazon FisioCare - Para - Brasil
Renata Megre Rachid, Jean Megre Junger Almeida