Compliance with CPAP treatment in patients with obstructive sleep apneas during the COVID-19 pandemic in two hospitals in the Federal Capital
DOI:
https://doi.org/10.31053/1853.0605.v80.n2.37719Keywords:
sleep apnea syndromes, adherence, COVID-19, pandemicAbstract
Introduction: CPAP therapy is the first line treatment for sleep apnea and its effectiveness depends on adherence. Face to face control and follow-up was limited due to the fact that our country was immersed in social isolation due to the COVID-19 pandemic as of March 2020. In order to assess whether CPAP adherence was maintained in patients with obstructive sleep apnea (OSA), in two hospitals during the COVID-19 pandemic and compare it with the pre-pandemic situation on a historical control basis in the city of Buenos Aires. Methods: Observational and retrospective study based on systematic data collection of adherence to CPAP and residual apnea-hypopnea index (AHI). For comparison, a historical control corresponding to the specular period (May to December of each year between 2016 and 2019) was used as a reference. Patients over 18 years ago with OSA on CPAP therapy more than 30 days of treatment were included. Patients with other chronic respiratory diseases requiring ventilation therapy (Bi-level, servo ventilation, volume-assured ventilation) were excluded. Results: 151 pre-pandemic patients and 127 from the pandemic period, respectively, were evaluated. Men 98 (65%) vs. 50 (60.3%) p: 0.9, age: 65.4 ± 11.9 vs. 63.6 ± 12.6 p: 0.22, body mass index 31.5 ± 5.0 vs. 31.2 ± 5.3 kg/m2 p: 0.6, respectively. In both centers, the most used treatment was fixed CPAP; 90 (59.6%) vs. 96 (75.6%) p: 0.005. There was an increase in compliance with it compared to the pre-pandemic period in minutes/night [341.4 95% CI 292.4 - 340.6 vs. 274.3 95% CI 208.5 - 267.4, p: 0.001] and residual AHI reduction [3.3 IC 95% 2.0 - 3.05 vs. 6.3 IC 95% 2.6 - 4.3 p: 0.006]. Conclusions: In the period of the COVID-19 pandemic, greater adherence to CPAP treatment was observed in patients with sleep apnea.
References
Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, Lamy M, Legall JR, Morris A, Spragg R. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994;149(3 Pt 1):818-24. doi: 10.1164/ajrccm.149.3.7509706.
Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, Mooser V, Preisig M, Malhotra A, Waeber G, Vollenweider P, Tafti M, Haba-Rubio J. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med. 2015;3(4):310-8. doi: 10.1016/S2213-2600(15)00043-0.
Kohler M, Stradling JR. Mechanisms of vascular damage in obstructive sleep apnea. Nat Rev Cardiol. 2010;7(12):677-85. doi: 10.1038/nrcardio.2010.145.
Rouatbi S, Ghannouchi I, Kammoun R, Ben Saad H. The Ventilatory and Diffusion Dysfunctions in Obese Patients with and without Obstructive Sleep Apnea-Hypopnea Syndrome. J Obes. 2020;2020:8075482. doi: 10.1155/2020/8075482.
Cade BE, Dashti HS, Hassan SM, Redline S, Karlson EW. Sleep Apnea and COVID-19 Mortality and Hospitalization. Am J Respir Crit Care Med. 2020;202(10):1462-1464. doi: 10.1164/rccm.202006-2252LE.
Maas MB, Kim M, Malkani RG, Abbott SM, Zee PC. Obstructive Sleep Apnea and Risk of COVID-19 Infection, Hospitalization and Respiratory Failure. Sleep Breath. 2021;25(2):1155-1157. doi: 10.1007/s11325-020-02203-0.
Thorpy M, Figuera-Losada M, Ahmed I, Monderer R, Petrisko M, Martin C, Akhtar J, Thorpy J, Haines C. Management of sleep apnea in New York City during the COVID-19 pandemic. Sleep Med. 2020;74:86-90. doi: 10.1016/j.sleep.2020.07.013.
Nogueira, F, Borsini E, Cambursano H, Smurra, M,
Dibur E, Franceschini C, Pérez-Chada D, Larrateguy L,
Nigro C. Guías prácticas de diagnóstico y tratamiento
del síndrome de apneas e hipopneas obstructivas del
sueño: Actualización 2019: Sección Sueño, Oxigenoterapia y Tratamientos Crónicos Domiciliarios. Asociación Argentina de Medicina Respiratoria. Rev. Am. Med. Respir 2019; 19 (1): 59-90.
Kreivi HR, Itäluoma T, Bachour A. Effect of ventilation therapy on mortality rate among obesity hypoventilation syndrome and obstructive sleep apnoea patients. ERJ Open Res. 2020; 11;6(2):00101-2019. doi: 10.1183/23120541.00101-2019.
Blanco M, Ernst G, Salvado A, Borsini E. Cumplimiento e intolerancias durante el tratamiento con presión positiva en las vías aéreas. Perfil de consultas externas en una unidad de sueño. Rev Am Med Resp 2021;2:151-158. ISSN 1852 - 236X.
Franceschini C, Garay A, Leske V, Valiensi S, Toledo A, Diez A, Nogueira F, Smurra M, Chumino Y, Martínez Fraga A, Leiva S y Borsini E. Recomendaciones de utilización de los dispositivos de presión positiva para trastornos respiratorios durante el sueño, en el contexto de pandemia por COVID-19. Rev Am Med Resp (Supl) 19:41-49. ISSN 1852 - 236X.
Berry RB, Brooks R, Gamaldo C, Harding SM, Lloyd RM, Quan SF, Troester MT, Vaughn BV. AASM Scoring Manual Updates for 2017 (Version 2.4). J Clin Sleep Med. 2017;13(5):665-666. doi: 10.5664/jcsm.6576.
Nogueira JF, Poyares D, Simonelli G, Leiva S, Carrillo-Alduenda JL, Bazurto MA, Terán G, Valencia-Flores M, Serra L, de Castro JR, Santiago-Ayala V, Pérez-Chada D, Franchi ME, Lucchesi L, Tufik S, Bittencourt L. Accessibility and adherence to positive airway pressure treatment in patients with obstructive sleep apnea: a multicenter study in Latin America. Sleep Breath. 2020;24(2):455-464. doi: 10.1007/s11325-019-01881-9.
Pascua J, Blanco M, Ernst G, Salvado A, Borsini EE. Compliance to Continuous Positive Airway Pressure therapy in patients with obstructive sleep apnea - long-term assessment. Sleep Sci. 2021;14(4):385-389. doi: 10.5935/1984-0063.20200118.
Attias D, Pepin JL, Pathak A. Impact of COVID-19 lockdown on adherence to continuous positive airway pressure by obstructive sleep apnoea patients. Eur Respir J. 2020;56(1):2001607. doi: 10.1183/13993003.01607-2020.
Miller MA, Cappuccio FP. A systematic review of COVID-19 and obstructive sleep apnoea. Sleep Med Rev. 2021;55:101382. doi: 10.1016/j.smrv.2020.101382.
Leone MJ, Sigman M, Golombek DA. Effects of lockdown on human sleep and chronotype during the COVID-19 pandemic. Curr Biol. 2020;30(16):R930-R931. doi: 10.1016/j.cub.2020.07.015.
Charčiūnaitė K, Gauronskaitė R, Šlekytė G, Danila E, Zablockis R. Evaluation of Obstructive Sleep Apnea Phenotypes Treatment Effectiveness. Medicina (Kaunas). 2021;57(4):335. doi: 10.3390/medicina57040335.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Universidad Nacional de Córdoba
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The generation of derivative works is allowed as long as it is not done for commercial purposes. The original work may not be used for commercial purposes.