Positive Airway Pressure Usage in Youth with Obstructive Sleep Apnea Following Transition to Adult Health Care
Indra Narang,1,2,* Tetyana Kendzerska,3,4,* Austin Heffernan,5 Uzair Malik,6 Carolina G Carvalho,7 Clodagh M Ryan8,9 1Department of Pediatrics, University of Toronto, Toronto, Canada; 2The Hospital for Sick Children, Toronto, Canada; 3Department of Medicine, Faculty of Medicine, Univ...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-02-01
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| Series: | Nature and Science of Sleep |
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| Online Access: | https://www.dovepress.com/positive-airway-pressure-usage-in-youth-with-obstructive-sleep-apnea-f-peer-reviewed-fulltext-article-NSS |
| _version_ | 1819276400748658688 |
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| author | Narang I Kendzerska T Heffernan A Malik U Carvalho CG Ryan CM |
| author_facet | Narang I Kendzerska T Heffernan A Malik U Carvalho CG Ryan CM |
| author_sort | Narang I |
| collection | DOAJ |
| description | Indra Narang,1,2,* Tetyana Kendzerska,3,4,* Austin Heffernan,5 Uzair Malik,6 Carolina G Carvalho,7 Clodagh M Ryan8,9 1Department of Pediatrics, University of Toronto, Toronto, Canada; 2The Hospital for Sick Children, Toronto, Canada; 3Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada; 4The Ottawa Hospital Research Institute, Ottawa, Canada; 5UBC, Faculty of Medicine, Vancouver, Canada; 6RCSI University of Medicine and Health Sciences, Dublin, Ireland; 7University Health Network; 8Department of Medicine, University of Toronto, Toronto, Canada; 9Sleep Research laboratory, KITE-UHN*These authors contributed equally to this workCorrespondence: Clodagh M Ryan, 9N-967 Toronto General Hospital, 585 University Ave., Toronto, Ontario, M5G 2N2, Canada, Email clodagh.ryan@uhn.caBackground: There is increasing prevalence of moderate to severe obstructive sleep apnea (OSA) in adolescents, the majority of whom receive treatment with positive airway pressure (PAP). Adherence to PAP is sub-optimal in adolescents with OSA. Moreover, the impact of transition from pediatric to adult healthcare system on PAP adherence is unknown. This is relevant as the transition period is a time of increased stress for youth with chronic illnesses.Research Question: Does PAP adherence decrease during the 1-year transition period from pediatric to adult healthcare system in those with OSA?Study Design and Methods: Youth previously diagnosed with persistent OSA and treated with PAP in a large academic center (Toronto, Canada) between 2017 and 2019 were enrolled on transfer from the pediatric to adult sleep clinic and followed at 12 months. Mixed-effects linear regression models were used to investigate the effect of time since the transfer on objective PAP adherence with adjustment for confounders.Results: Among the 45 enrolled participants, 42.2% were female, the median age was 18 years (interquartile range [IQR]: 17– 18), median BMI was 30.3 (IQR: 24.0– 37.1), and the median apnea-hypopnea index (AHI) was 17.8 events/hour (11.8– 30.7). In univariate analysis, we observed a significant reduction in the 12-month average PAP usage in days used at follow-up compared to PAP use at the time of enrolment: median of 5.0 hours/day (IQR: 1.3– 8.0) vs 2.6 hours/day (0.0– 6.4), p < 0.0001. Following adjustment for age, level of education, employment status and living arrangement, the 12-month average PAP usage in days remained significantly decreased at follow-up compared to at the time of enrolment: change in hours of − 1.14; 95% CI − 2.27 to − 0.01.Interpretation: Among youth with OSA treated with PAP, there is a clinically significant reduction in PAP adherence over the first year during the transition from pediatric to adult health care.Keywords: CPAP adherence, transition care, obstructive sleep apnea, young adults, CPAP compliance |
| first_indexed | 2024-12-23T23:39:37Z |
| format | Article |
| id | doaj.art-6622a2fd0dd2466086a44e9e4b3faac7 |
| institution | Directory Open Access Journal |
| issn | 1179-1608 |
| language | English |
| last_indexed | 2024-12-23T23:39:37Z |
| publishDate | 2022-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Nature and Science of Sleep |
| spelling | doaj.art-6622a2fd0dd2466086a44e9e4b3faac72022-12-21T17:25:44ZengDove Medical PressNature and Science of Sleep1179-16082022-02-01Volume 1415316372615Positive Airway Pressure Usage in Youth with Obstructive Sleep Apnea Following Transition to Adult Health CareNarang IKendzerska THeffernan AMalik UCarvalho CGRyan CMIndra Narang,1,2,* Tetyana Kendzerska,3,4,* Austin Heffernan,5 Uzair Malik,6 Carolina G Carvalho,7 Clodagh M Ryan8,9 1Department of Pediatrics, University of Toronto, Toronto, Canada; 2The Hospital for Sick Children, Toronto, Canada; 3Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada; 4The Ottawa Hospital Research Institute, Ottawa, Canada; 5UBC, Faculty of Medicine, Vancouver, Canada; 6RCSI University of Medicine and Health Sciences, Dublin, Ireland; 7University Health Network; 8Department of Medicine, University of Toronto, Toronto, Canada; 9Sleep Research laboratory, KITE-UHN*These authors contributed equally to this workCorrespondence: Clodagh M Ryan, 9N-967 Toronto General Hospital, 585 University Ave., Toronto, Ontario, M5G 2N2, Canada, Email clodagh.ryan@uhn.caBackground: There is increasing prevalence of moderate to severe obstructive sleep apnea (OSA) in adolescents, the majority of whom receive treatment with positive airway pressure (PAP). Adherence to PAP is sub-optimal in adolescents with OSA. Moreover, the impact of transition from pediatric to adult healthcare system on PAP adherence is unknown. This is relevant as the transition period is a time of increased stress for youth with chronic illnesses.Research Question: Does PAP adherence decrease during the 1-year transition period from pediatric to adult healthcare system in those with OSA?Study Design and Methods: Youth previously diagnosed with persistent OSA and treated with PAP in a large academic center (Toronto, Canada) between 2017 and 2019 were enrolled on transfer from the pediatric to adult sleep clinic and followed at 12 months. Mixed-effects linear regression models were used to investigate the effect of time since the transfer on objective PAP adherence with adjustment for confounders.Results: Among the 45 enrolled participants, 42.2% were female, the median age was 18 years (interquartile range [IQR]: 17– 18), median BMI was 30.3 (IQR: 24.0– 37.1), and the median apnea-hypopnea index (AHI) was 17.8 events/hour (11.8– 30.7). In univariate analysis, we observed a significant reduction in the 12-month average PAP usage in days used at follow-up compared to PAP use at the time of enrolment: median of 5.0 hours/day (IQR: 1.3– 8.0) vs 2.6 hours/day (0.0– 6.4), p < 0.0001. Following adjustment for age, level of education, employment status and living arrangement, the 12-month average PAP usage in days remained significantly decreased at follow-up compared to at the time of enrolment: change in hours of − 1.14; 95% CI − 2.27 to − 0.01.Interpretation: Among youth with OSA treated with PAP, there is a clinically significant reduction in PAP adherence over the first year during the transition from pediatric to adult health care.Keywords: CPAP adherence, transition care, obstructive sleep apnea, young adults, CPAP compliancehttps://www.dovepress.com/positive-airway-pressure-usage-in-youth-with-obstructive-sleep-apnea-f-peer-reviewed-fulltext-article-NSScpap adherencetransition careobstructive sleep apneayoung adultscpap compliance |
| spellingShingle | Narang I Kendzerska T Heffernan A Malik U Carvalho CG Ryan CM Positive Airway Pressure Usage in Youth with Obstructive Sleep Apnea Following Transition to Adult Health Care Nature and Science of Sleep cpap adherence transition care obstructive sleep apnea young adults cpap compliance |
| title | Positive Airway Pressure Usage in Youth with Obstructive Sleep Apnea Following Transition to Adult Health Care |
| title_full | Positive Airway Pressure Usage in Youth with Obstructive Sleep Apnea Following Transition to Adult Health Care |
| title_fullStr | Positive Airway Pressure Usage in Youth with Obstructive Sleep Apnea Following Transition to Adult Health Care |
| title_full_unstemmed | Positive Airway Pressure Usage in Youth with Obstructive Sleep Apnea Following Transition to Adult Health Care |
| title_short | Positive Airway Pressure Usage in Youth with Obstructive Sleep Apnea Following Transition to Adult Health Care |
| title_sort | positive airway pressure usage in youth with obstructive sleep apnea following transition to adult health care |
| topic | cpap adherence transition care obstructive sleep apnea young adults cpap compliance |
| url | https://www.dovepress.com/positive-airway-pressure-usage-in-youth-with-obstructive-sleep-apnea-f-peer-reviewed-fulltext-article-NSS |
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