Adherence to continuous positive airway pressure in adults with an intellectual disability

• Published in: Sleep medicine Vol. 34; pp. 234 - 239
• Main Authors: Luijks, Kim A., MD, Vandenbussche, Nele L., MD, Pevernagie, Dirk, MD PhD, Overeem, Sebastiaan, MD, PhD, Pillen, Sigrid, MD, PhD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2017
• Subjects: Comorbidity; Continuous positive airway pressure; Continuous Positive Airway Pressure - adverse effects; Down syndrome; Feasibility Studies; Female; Humans; Intellectual Disability - complications; Male; Mental retardation; Middle Aged; Neurology; Obstructive sleep apnea; Patient Compliance; Retrospective Studies; Severity of Illness Index; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - psychology; Sleep Apnea, Obstructive - therapy; Sleep Medicine; Treatment; Continuous Positive Airway Pressure; obstructive sleep apnea; mental retardation; treatment; AHI; CPAP; Down syndrome; ID; OSA; apnea hypopnea index; intellectual disability; Treatment; Continuous positive airway pressure; Mental retardation; Obstructive sleep apnea
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2017.02.029

Abstract Study Objectives This retrospective study evaluated the feasibility of continuous positive airway pressure (CPAP) therapy in adults with intellectual disabilities (ID). Methods CPAP therapy of 24 obstructive sleep apnea syndrome (OSA) patients with ID were compared to age- and sex-matched adults with normal cognitive functioning. All ID patients received an intensive in-hospital training protocol to stimulate adherence. Good adherence was defined as a use of >70% of the nights and > 4 h/night. Influencing factors were assessed. Results Baseline apnea-hypopnea index (AHI) was significantly higher in ID patients compared to controls (median 34/h (range 6-101) versus 17/h (range 5-50), p=0.013). The required average duration of in-hospital training was four nights (range 1-8 days). At 6 weeks, 60% of the ID patients showed good adherence and 65% at 6 months, compared to 71% and 50% respectively in the control group. Mean CPAP use per night was equal in both groups both at six weeks (5h in both groups) and six months (ID 6:30h vs control 5h (p=0.18)). CPAP adherence correlated with baseline AHI in the control patients, but not in ID patients. There was no correlation between CPAP adherence and the level of ID or the degree of support at home. Conclusions Using an intensive training protocol it is very well feasible to apply CPAP therapy in OSA patients with any degree of ID. CPAP adherence in ID patients was comparable to the control patients in this study as well as to previously published adherence numbers.