Diferencias por sexo respecto al impacto de una sesión de adaptación en pacientes colombianos con apnea obstructiva del sueño y mala adherencia a dispositivos de presión positiva

Publicado

2022-07-01

Sex differences regarding the impact of a standardized adaptation session in Colombian patients with obstructive sleep apnea and poor adherence to positive airway pressure devices

Diferencias por sexo respecto al impacto de una sesión de adaptación en pacientes colombianos con apnea obstructiva del sueño y mala adherencia a dispositivos de presión positiva

Palabras clave:

Sleep Apnea, Continuous Positive Airway Pressure, Patient Compliance (en)
Apnea del sueño, Presión positiva en la vía aérea, Adherencia (es)

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Autores/as

María Angélica Bazurto-Zapata Fundación Neumológica Colombiana - Laboratorio de Sueño - Bogotá D.C. - Colombia. https://orcid.org/0000-0001-9563-0539
Fredy Valderrama Fundación Neumológica Colombiana - Laboratorio de Sueño - Bogotá D.C. - Colombia. https://orcid.org/0000-0002-6787-4349
Federico Fernández Fundación Neumológica Colombiana - Laboratorio de Sueño - Bogotá D.C. - Colombia. https://orcid.org/0000-0002-8245-5548
Mauricio González-García Fundación Neumológica Colombiana - Departamento de Investigación - Bogotá D.C. - Colombia. https://orcid.org/0000-0003-0768-1972

Resumen (en)
Resumen (es)

Introduction: Positive airway pressure (PAP) is the most effective treatment for obstructive sleep apnea (OSA) but adherence to this device is poor. The Sleep and Breathing Disorders Clinic of Fundación Neumológica Colombiana (FNC) has a standardized adaptation session (SAS) aimed at patients with difficulties in using PAP devices.

Objective: To evaluate the impact of a SAS in short-term adherence to PAP therapy in patients with OSA, and to determine differences by sex.

Materials and methods: Before-and-after single cohort study conducted in 40 people aged ≥18 years with an apnea–hypopnea index ≥15/hour and treated at the FNC, Bogotá D.C. (Colombia) between 2015 and 2017, who attended a SAS due to poor adherence to PAP therapy (defined as <4 hours use in 70% of nights). Data on the hours of use of the PAP device and the percentage of days in which it was used >4 hours were recorded before and after the intervention to evaluate changes in patients’ adherence. Descriptive statistics were used for data analysis. The paired samples t-test was used for the comparison of variables before and after the intervention.

Results: A significant increase was observed in PAP device use (1.8 hours, 95%CI: 1.3-2.3; p<0.001) and in the percentage of days it was used >4 hours (35.6%, 95%CI: 26.0-45.3; p<0.001). Among men, the increase was higher in both cases (2.3 hours, 95%CI: 1.7-2.9; p=0.029 and 47.8%, 95%CI: 32.9-62.8; p=0.029).

Conclusion: The SAS offered by the FNC, which includes education strategies and the identification and solving of barriers hindering the use of PAP devices, significantly increased the hours of PAP device use and the percentage of days in which it was used >4 hours in the study population, particularly in men.

Introducción. La terapia de presión positiva en la vía aérea (PAP) es el tratamiento más efectivo de la apnea obstructiva del sueño (AOS); sin embargo, la adherencia no es óptima. La clínica de trastornos respiratorios del sueño de la Fundación Neumológica Colombiana (FNC) tiene una sesión de adaptación estandarizada (SAE) dirigida a pacientes con dificultades en el uso de equipo PAP.

Objetivo. Evaluar el impacto de una SAE en la adherencia a corto plazo a la terapia de PAP en pacientes con AOS y determinar diferencias por sexo.

Materiales y métodos. Estudio de cohorte única de antes y después realizado en 40 pacientes ≥18 años con un índice de apnea-hipopnea ≥15/hora atendidos en la FNC, en Bogotá D.C., Colombia, entre 2015 y 2017 y que asistieron a una SAE debido a una pobre adherencia a la terapia de PAP (<4 horas de uso el 70% de las noches). Se registraron los datos de uso en horas del equipo de PAP y el porcentaje de días en que se usó más de 4 horas antes y después de la intervención. Los datos se analizaron mediante estadística descriptiva y se empleó la prueba T de muestras emparejadas para comparar las variables antes y después de la intervención.

Resultados. Se observó un aumento significativo después de la SAE en las horas de uso del equipo de PAP (1.8 horas, IC95%: 1.3-2.3; p<0.001) y del porcentaje de días en que su uso fue >4 horas (35.6%, IC95%: 26.0-45.3; p<0.001); el incremento fue mayor en los hombres en ambos casos (2.3 horas, IC95%: 1.7-2.9; p=0.029, y 47.8%, IC95%: 32.9-62.8; p=0.029).

Conclusión. La SAE que brinda la FNC, la cual incluye estrategias educativas y la identificación y solución de barreras que dificultan el uso del equipo de PAP, aumentó de forma significativa las horas de uso de los dispositivos de PAP y el porcentaje de días con uso >4 horas en la población de estudio, en particular en los hombres.

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