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Influencing factors on CPAP adherence and anatomic characteristics of upper airway in OSA subjects.

Abstract Although continuous positive airway pressure (CPAP) is the most effective treatment modality, poor adherence still remains a problem for obstructive sleep apnea (OSA) treatment and there is little evidence regarding how this might be improved. This study aims to analyze the anatomic and clinical factors of OSA subjects who failed to comply with CPAP therapy.The medical records of 47 OSA subjects who received CPAP therapy as a first-line treatment modality were retrospectively reviewed. The medical records were reviewed for demographic and polysomnographic data and anatomic findings of the nasal cavity and oropharynx.24 patients who adhered to CPAP therapy and 23 patients who were nonadherent were enrolled in the study. There were no statistically significant differences in sleep parameters between CPAP-adherent patients and CPAP nonadherent subjects. Mean body mass index of CPAP nonadherent group was significantly higher than CPAP adherent group. Higher grades of septal deviation and hypertrophic change of the inferior turbinate were observed more in the CPAP nonadherent group. In addition, CPAP nonadherent subjects showed considerably bigger tonsils and higher grade palatal position comparing with the CPAP adherent subjects. Subjective discomfort including inconvenience, mouth dryness, and chest discomfort were the main problems for OSA subjects who did not comply with CPAP therapy.Excessive upper airway blockage in the nasal cavity and oropharynx was predominant in CPAP nonadherent subjects, which might cause the reported subjective discomfort that reduces CPAP compliance. Therefore, resolution of these issues is needed to enhance CPAP compliance for control of OSA.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29390419
OWN - NLM
STAT- In-Process
LR  - 20180202
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 51
DP  - 2017 Dec
TI  - Influencing factors on CPAP adherence and anatomic characteristics of upper
      airway in OSA subjects.
PG  - e8818
LID - 10.1097/MD.0000000000008818 [doi]
AB  - Although continuous positive airway pressure (CPAP) is the most effective
      treatment modality, poor adherence still remains a problem for obstructive sleep 
      apnea (OSA) treatment and there is little evidence regarding how this might be
      improved. This study aims to analyze the anatomic and clinical factors of OSA
      subjects who failed to comply with CPAP therapy.The medical records of 47 OSA
      subjects who received CPAP therapy as a first-line treatment modality were
      retrospectively reviewed. The medical records were reviewed for demographic and
      polysomnographic data and anatomic findings of the nasal cavity and oropharynx.24
      patients who adhered to CPAP therapy and 23 patients who were nonadherent were
      enrolled in the study. There were no statistically significant differences in
      sleep parameters between CPAP-adherent patients and CPAP nonadherent subjects.
      Mean body mass index of CPAP nonadherent group was significantly higher than CPAP
      adherent group. Higher grades of septal deviation and hypertrophic change of the 
      inferior turbinate were observed more in the CPAP nonadherent group. In addition,
      CPAP nonadherent subjects showed considerably bigger tonsils and higher grade
      palatal position comparing with the CPAP adherent subjects. Subjective discomfort
      including inconvenience, mouth dryness, and chest discomfort were the main
      problems for OSA subjects who did not comply with CPAP therapy.Excessive upper
      airway blockage in the nasal cavity and oropharynx was predominant in CPAP
      nonadherent subjects, which might cause the reported subjective discomfort that
      reduces CPAP compliance. Therefore, resolution of these issues is needed to
      enhance CPAP compliance for control of OSA.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Park, Pona
AU  - Park P
AD  - Department of Otorhinolaryngology, Seoul National University College of Medicine,
      Seoul, Korea.
FAU - Kim, Jinil
AU  - Kim J
FAU - Song, Yoon Jae
AU  - Song YJ
FAU - Lim, Jae Hyun
AU  - Lim JH
FAU - Cho, Sung Woo
AU  - Cho SW
FAU - Won, Tae-Bin
AU  - Won TB
FAU - Han, Doo Hee
AU  - Han DH
FAU - Kim, Dong-Young
AU  - Kim DY
FAU - Rhee, Chae Seo
AU  - Rhee CS
FAU - Kim, Hyun Jik
AU  - Kim HJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2018/02/03 06:00
MHDA- 2018/02/03 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/03 06:00 [medline]
AID - 10.1097/MD.0000000000008818 [doi]
AID - 00005792-201712220-00006 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(51):e8818. doi: 10.1097/MD.0000000000008818.