Comparing adherence of continuous and automatic positive airway pressure
(CPAP and APAP) in obstructive sleep apnea (OSA) children
Abstract
Objectives: The treatment outcomes of pediatric obstructive sleep apnea
(OSA) are affected by positive airway pressure (PAP) therapy adherence,
which may be affected by the type of machine used. Continuous PAP (CPAP)
machines deliver a continuous and fixed air pressure level, whereas
automatic PAP (APAP) machines automatically adjust the pressure to meet
changing needs during sleep. The adherence, tolerance and consistency of
OSA-children’s use of CPAP and APAP machines were compared. Study
design: One-year, observational cohort study Methods: Twenty-seven OSA
children were enrolled. Fourteen (52%) used CPAP, and 13 (48%) used
APAP. The adherence, tolerance, and consistency of the PAP usage by the
2 groups were compared. Results: Overall, 11 of the 27 children (41%)
showed good PAP adherence. The CPAP patients averaged 4.9 hours of
machine usage on the days used, for 60% of days, with 6 of 14 (43%)
demonstrating good adherence. In comparison, the APAP patients averaged
3.2 hours for 55% of days, with 5 of 13 (38%) exhibiting good
adherence. The 2 groups showed no differences in their adherence,
tolerance, or consistency of machine usage (P values, 0.609, 0.720, and
0.816, respectively). Although the adherence of both groups improved in
the second six months, it was without statistical significance (P
values, 0.400 and 0.724). Age, sex, baseline apnea-hypopnea index,
comorbidities, prescribed period, machine type, mask type, and caregiver
education-level were not risk factors for poor PAP adherence.
Conclusions: No differences in the adherence, tolerance, or consistency
of the children’s use of CPAP and APAP were revealed.