J Rhinol.  2022 Nov;29(3):148-154. 10.18787/jr.2022.00417.

Compliance After Re-Prescription for Positive Airway Pressure in Obstructive Sleep Apnea Patients Who Failed Positive Airway Pressure Therapy

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea

Abstract

Background and Objectives
Little is known about studies evaluating positive airway pressure (PAP) compliance after re-prescription. Therefore, the aim of this study was to investigate PAP compliance after re-prescription in obstructive sleep apnea (OSA) patients who failed initial PAP therapy.
Methods
We retrospectively reviewed OSA patients who had received a re-prescription for PAP from March 2020 to June 2021. We compared the compliance rate between initial prescription and re-prescription for PAP and investigated the reasons for PAP failure after the first prescription.
Results
A total of 10 consecutive OSA patients (mean age=45.6±13.7 years and male:female=8:2) who received a re-prescription for PAP were included. Of them, 8 patients (80%) met the compliance criteria (i.e., Korean National Health Insurance criteria) for PAP after re-prescription. The compliance rate increased from 36.3±18.2% (initial prescription) to 61.3±28.8% (re-prescription); this was not of statistical significance (p=0.074). PAP/mask-related discomfort was the most common reason for PAP failure, followed by nasal obstruction, unintentional mask removal, and pressure-related discomfort.
Conclusion
Even if initial PAP therapy fails, the proportion of patients who meet the compliance criteria may be improved through various forms of clinical aid and support after re-prescription of PAP.

Keyword

Obstructive sleep apnea; Positive airway pressure; Re-prescription; Compliance

Reference

References

1. Guilleminault C, Tilkian A, Dement WC. The sleep apnea syndromes. Annu Rev Med. 1976; 27:465–84.
Article
2. American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien (IL): American Academy of Sleep Medicine;2014.
3. Kim J, In K, Kim J, You S, Kang K, Shim J, et al. Prevalence of sleepdisordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med. 2004; 170(10):1108–13.
Article
4. Gottlieb DJ, Punjabi NM. Diagnosis and management of obstructive sleep apnea: a review. JAMA. 2020; 323(14):1389–400.
Article
5. Shamsuzzaman AS, Gersh BJ, Somers VK. Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA. 2003; 290(14):1906–14.
6. Nieto FJ, Peppard PE, Young T, Finn L, Hla KM, Farré R. Sleep-disordered breathing and cancer mortality: results from the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med. 2012; 186(2):190–4.
7. Yaffe K, Laffan AM, Harrison SL, Redline S, Spira AP, Ensrud KE, et al. Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA. 2011; 306(6):613–9.
Article
8. Epstein LJ, Kristo D, Strollo PJ Jr, Friedman N, Malhotra A, Patil SP, et al. Clinical guideline for the evaluation, management and longterm care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009; 5(3):263–76.
9. Sullivan CE, Issa FG, Berthon-Jones M, Eves L. Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet. 1981; 1(8225):862–5.
Article
10. Choi JH. Positive airway pressure prescription and management for patients with obstructive sleep apnea. J Rhinol. 2020; 27(2):73–82.
Article
11. American Academy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Version 2.6. Darien (IL): American Academy of Sleep Medicine;2020.
12. McArdle N, Devereux G, Heidarnejad H, Engleman HM, Mackay TW, Douglas NJ. Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med. 1999; 159(4 Pt 1):1108–14.
Article
13. Rauscher H, Popp W, Wanke T, Zwick H. Acceptance of CPAP therapy for sleep apnea. Chest. 1991; 100(4):1019–23.
Article
14. Engleman HM, Wild MR. Improving CPAP use by patients with the sleep apnoea/hypopnoea syndrome (SAHS). Sleep Med Rev. 2003; 7(1):81–99.
Article
15. Kim JH, Kwon MS, Song HM, Lee BJ, Jang YJ, Chung YS. Compliance with positive airway pressure treatment for obstructive sleep apnea. Clin Exp Otorhinolaryngol. 2009; 2(2):90–6.
Article
16. Sin DD, Mayers I, Man GC, Pawluk L. Long-term compliance rates to continuous positive airway pressure in obstructive sleep apnea: a population-based study. Chest. 2002; 121(2):430–5.
Article
17. Choi JB, Lee SH, Jeong DU. Compliance of nasal continuous positive airway pressure in patients with obstructive sleep apnea syndrome. Sleep Med Psychophysiol. 2006; 13(1):27–32.
18. Han EK, Yoon IY, Chung S. The compliance and effect of CPAP in obstructive sleep apnea syndrome. Sleep Med Psychophysiol. 2006; 13(2):52–8.
19. Park JH, Kang JH, Seo MG, Kwon HN, Kim SD, Cho KS. Effect of national health insurance coverage on adherence to positive airway pressure therapy in obstructive sleep apnea patients. Sleep Med Res. 2020; 11(2):140–4.
Article
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