Literature DB >> 23372270

Flexible positive airway pressure improves treatment adherence compared with auto-adjusting PAP.

Yuichi Chihara1, Tomomasa Tsuboi, Takefumi Hitomi, Masanori Azuma, Kimihiko Murase, Yoshiro Toyama, Yuka Harada, Kensaku Aihara, Kiminobu Tanizawa, Tomohiro Handa, Chikara Yoshimura, Toru Oga, Kazuhiko Yamamoto, Michiaki Mishima, Kazuo Chin.   

Abstract

STUDY
OBJECTIVES: There are no clinical data comparing adherence and quality of life between auto-adjusting positive airway pressure (APAP) and two different flex positive airway pressure (PAP) devices (A-Flex, C-Flex) in patients with obstructive sleep apnea (OSA). DESIGN AND
SETTING: Ninety-three patients in whom OSA was newly diagnosed were randomly assigned to receive 3 mo of APAP (n = 31), APAP with C-Flex (n = 31), or APAP with A-Flex (n = 31). Objective adherence was determined after 3 mo of CPAP treatment, and the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Calgary Sleep Apnea Quality of Life Index (SAQLI) were examined at baseline and after 3 mo. After 3 mo, patients in the APAP with A-Flex group and those in the APAP with C-Flex group were crossed over and those in the APAP group were switched to A-Flex for an additional 3 mo. MEASUREMENTS AND
RESULTS: The groups were similar demographically. Treatment adherence during the first 3 mo was significantly greater in the APAP with C-Flex group (APAP with C-Flex: 5.19 ± 1.84 h/night versus APAP: 3.96 ± 1.66 h/night versus APAP with A-Flex: 4.27 ± 2.12 h/night, P = 0.04). There was a significant improvement in two of four of the SAQLI domain scores and in the ESS and PSQI in the APAP with C-Flex group. Adherence significantly improved among the poor compliers (< 4 h/night of use) in the APAP group after change to APAP with A-Flex (P = 0.01).
CONCLUSIONS: Of these three modes of PAP delivery, adherence was greatest with APAP with C-Flex. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00873977.

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Mesh:

Year:  2013        PMID: 23372270      PMCID: PMC3543062          DOI: 10.5665/sleep.2378

Source DB:  PubMed          Journal:  Sleep        ISSN: 0161-8105            Impact factor:   5.849


  33 in total

1.  Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial.

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Review 2.  Flexible pressure delivery modification of continuous positive airway pressure for obstructive sleep apnea does not improve compliance with therapy: systematic review and meta-analysis.

Authors:  Jessie P Bakker; Nathaniel S Marshall
Journal:  Chest       Date:  2010-12-30       Impact factor: 9.410

3.  Comparative study of autotitrating and fixed-pressure CPAP in the home: a randomized, single-blind crossover trial.

Authors:  Craig Hukins
Journal:  Sleep       Date:  2004-12-15       Impact factor: 5.849

4.  Treatment adherence and outcomes in flexible vs standard continuous positive airway pressure therapy.

Authors:  Mark S Aloia; Michael Stanchina; J Todd Arnedt; Atul Malhotra; Richard P Millman
Journal:  Chest       Date:  2005-06       Impact factor: 9.410

5.  Normalization of memory performance and positive airway pressure adherence in memory-impaired patients with obstructive sleep apnea.

Authors:  Molly E Zimmerman; J Todd Arnedt; Michael Stanchina; Richard P Millman; Mark S Aloia
Journal:  Chest       Date:  2006-12       Impact factor: 9.410

6.  A new method for measuring daytime sleepiness: the Epworth sleepiness scale.

Authors:  M W Johns
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Review 7.  Pressure modification for improving usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea.

Authors:  Ian Smith; Toby J Lasserson
Journal:  Cochrane Database Syst Rev       Date:  2009-10-07

8.  Randomised trial of compliance with flexible (C-Flex) and standard continuous positive airway pressure for severe obstructive sleep apnea.

Authors:  Nathaniel S Marshall; Alister M Neill; Angela J Campbell
Journal:  Sleep Breath       Date:  2008-05-31       Impact factor: 2.816

9.  Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning.

Authors:  Terri E Weaver; Greg Maislin; David F Dinges; Thomas Bloxham; Charles F P George; Harly Greenberg; Gihan Kader; Mark Mahowald; Joel Younger; Allan I Pack
Journal:  Sleep       Date:  2007-06       Impact factor: 5.849

10.  Longitudinal comparison study of pressure relief (C-Flex) vs. CPAP in OSA patients.

Authors:  Diana C Dolan; Renata Okonkwo; Florian Gfullner; J Randall Hansbrough; Richard J Strobel; Leon Rosenthal
Journal:  Sleep Breath       Date:  2008-06-13       Impact factor: 2.816

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  9 in total

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2.  Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment.

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Review 3.  APAP, BPAP, CPAP, and New Modes of Positive Airway Pressure Therapy.

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4.  Improving Positive Airway Pressure Adherence in Children.

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Journal:  Sleep Med Clin       Date:  2014-06-01

5.  Pressure-Relief Features of Fixed and Autotitrating Continuous Positive Airway Pressure May Impair Their Efficacy: Evaluation with a Respiratory Bench Model.

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6.  PAP Adherence and Nasal Resistance. A Randomized Controlled Trial of CPAPflex versus CPAP in World Trade Center Responders.

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7.  Pressure modification or humidification for improving usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea.

Authors:  Barry Kennedy; Toby J Lasserson; Dariusz R Wozniak; Ian Smith
Journal:  Cochrane Database Syst Rev       Date:  2019-12-02

8.  Poor versus good sleepers in patients under treatment for sleep-related breathing disorders: better is not good enough.

Authors:  Christian Veauthier
Journal:  Neuropsychiatr Dis Treat       Date:  2014-01-17       Impact factor: 2.570

9.  The importance of clinical monitoring for compliance with Continuous Positive Airway Pressure.

Authors:  Lucas B Pelosi; Mariana L C Silveira; Alan L Eckeli; Emilia M P C Chayamiti; Leila A Almeida; Heidi H Sander; Daniel S Küpper; Fabiana C P Valera
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  9 in total

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