Compliance with CPAP treatment in patients with obstructive sleep apneas during the COVID-19 pandemic in two hospitals in the Federal Capital

Authors

  • Veronica Jaritos Hospital de Clínicas José de San Martín
  • Magalí Blanco Unidad de Sueño y Ventilación. Hospital Británico de Buenos Aires.
  • Facundo Nogueira Unidad de Sueño. Hospital de Clínicas José de San Martín. Universidad de Buenos Aires. Argentina
  • Vanina Giovini Unidad de Sueño. Hospital de Clínicas José de San Martín. Universidad de Buenos Aires. Argentina
  • Eduardo Borsini Unidad de Sueño y Ventilación. Hospital Británico de Buenos Aires.

DOI:

https://doi.org/10.31053/1853.0605.v80.n2.37719

Keywords:

sleep apnea syndromes, adherence, COVID-19, pandemic

Abstract

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.

Author Biographies

  • Veronica Jaritos, Hospital de Clínicas José de San Martín

    Licenciada en Kinesiología y Fisiatría. Servicio de neumonología. Laboratorio del sueño. Hospital de Clínicas José de San Martín. Buenos Aires, Argentina

  • Magalí Blanco, Unidad de Sueño y Ventilación. Hospital Británico de Buenos Aires.

    Licenciada. Kinesiologa respiratoria. Unidad de Sueño y Ventilación del Hospital Británico de Buenos Aires. Argentina.

  • Facundo Nogueira, Unidad de Sueño. Hospital de Clínicas José de San Martín. Universidad de Buenos Aires. Argentina

    Jefe de la Unidad de Sueño. Medico acreditado en medicina del sueño. Hospital de Clinicas. Buenos Aires Argentina

  • Vanina Giovini, Unidad de Sueño. Hospital de Clínicas José de San Martín. Universidad de Buenos Aires. Argentina

    Medica neumonologa. Medica de planta de la Unidad de Sueño del Hospital de Clínicas. Buenos Aires. Argentina.

  • Eduardo Borsini, Unidad de Sueño y Ventilación. Hospital Británico de Buenos Aires.

    Medico neumonólogo. Acreditado en Medicina del Sueño. Unidad de Sueño y Ventilación del Hospital Británico de Buenos Aires. Argentina.

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.

Published

2023-06-30

Issue

Section

Original Papers

How to Cite

1.
Compliance with CPAP treatment in patients with obstructive sleep apneas during the COVID-19 pandemic in two hospitals in the Federal Capital. Rev Fac Cien Med Univ Nac Cordoba [Internet]. 2023 Jun. 30 [cited 2024 Sep. 28];80(2):106-11. Available from: https://revistas.unc.edu.ar/index.php/med/article/view/37719

Similar Articles

31-40 of 269

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)