0599 Positive Airway Pressure Barriers Reduction in Response to Group Sleep Apnea Management Clinic

• Published in: Sleep (New York, N.Y.) Vol. 41; no. suppl_1; p. A222
• Main Authors: Syed, M, Wang, L, Kaw, S, Mehra, R, Moul, D E, Vanek, R, Campean, T, Foldvary-Schaefer, N, Walia, H K
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 27.04.2018
• Subjects: Sleep apnea
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/zsy061.598

Abstract Introduction Positive airway pressure (PAP) therapy is the cornerstone therapy for obstructive sleep apnea and barriers to usage can preclude realization of optimal PAP benefits. Addressing barriers in our Sleep Apnea Management (SAM) clinic, an intervention developed to leverage group-based dynamics focused on improving PAP adherence, is unknown. We hypothesize that the SAM clinic intervention will reduce PAP barriers on patients already on PAP. Methods SAM clinic visits from February- April 2017 were analyzed retrospectively in 21 patients. PAP barriers were collected via questionnaires and included: air leak, mask irritation, mask fitting challenges, nasal congestion, mask-related claustrophobia, aerophagia, nose /mouth dryness and pressure intolerance. The change in barrier question status from baseline to 3-month follow-up was analyzed using the exact McNemar’s test. Results Mean age was 62.9 (SD 12.6) years, 52.4% were male, and 90% were non-Hispanic. At baseline, the following barriers were present: air leak (n=7, 33%), mask irritation, (n=7, 33%), mask claustrophobia (n=6, 29%), aerophagia (n=3, 14%), after follow up 100 % of these barriers were resolved. Mask fitting issues (n=11/21, 52%), after follow up (n=10/11, 91%) were resolved; nasal congestion issues (n=8/21, 38%) after follow up (n=7/8, 88%) were resolved; pressure intolerance (n=10/20, 50%) after follow up (n=9/10, 90%) were resolved; nose/mouth dryness (n=14/20, 70%) after follow up (n=10/14,71%) were resolved. (p<0.05 for all except aerophagia). Conclusion Despite the small sample size, we observed both statistically significant and clinically relevant improvements in patient-reported PAP barriers in response to the SAM clinic intervention. This result indicates a group setting such as SAM clinic can play a critical role in reducing barriers. However, further extended trials are needed to consolidate these results. Support (If Any) We acknowledge The Neurological Institute Center at Cleveland Clinic for providing data and biostatistical support.