Intervenciones para la optimización de adherencia a dispositivos de presión positiva de vía aérea en pacientes con SAHOS
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Abstract
El tratamiento con dispositivos de presión positiva de vía aérea superior (DPPVAS), para el síndrome de apnea obstructiva del sueño (SAHOS), suele tener una mala adherencia. Objetivo: Identificar las causas más frecuentes de mala adaptación en nuestro medio, evaluar las intervenciones y los resultados obtenidos y definir porcentaje de adherencia al tratamiento posterior. Materiales y métodos: Presentamos una serie de casos, 109 pacientes en uso de CPAP quienes consultaron por mala adaptación o deseo de abandonar la terapia, a los que se les realizó intervención, y posterior seguimiento; las intervenciones se realizaron, desde concientización de beneficios, seguimiento, cambio o adición de accesorios a los dispositivos, hasta cirugía para mejorar la adherencia al tratamiento. Resultados y conclusiones: La mayor causa en nuestra serie, de poca tolerancia a los DPPVAS, son las relacionadas al uso de una máscara inadecuada, que generan sensación de ahogo y claustrofobia. Las intervenciones realizadas, en general, lograron mejorar en un 72,5% de la serie la tolerancia.
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Este artículo es publicado por la Revista Acta de Otorrinolaringología & Cirugía de Cabeza y Cuello.
Este es un artículo de acceso abierto, distribuido bajo los términos de la LicenciaCreativeCommons Atribución-CompartirIgual 4.0 Internacional.( http://creativecommons.org/licenses/by-sa/4.0/), que permite el uso no comercial, distribución y reproducción en cualquier medio, siempre que la obra original sea debidamente citada.
eISSN: 2539-0856
ISSN: 0120-8411
References
Sullivan CE, Berthon-Jones M, Issa FG, Eves L. Reversal of obstructive sleep apnea by continuous positive airway pressure applied through the nose. Lancet. 1981; 862-865.
Phillipson EA. Sleep Apnea: a major public health problem. N Eng J Med. 1993; 328 (17): 1271-1273.
Kakkar R, Berry R. Positive airway pressure treatment for obstructive sleep apnea. Chest. 2007; 132; 1057-1072.
Woodson B, Franco R. Physiology of sleep disordered breathing. Otolaryngol Clin N Am. 2007; 40: 691-711.
Mortimore IL, Whittle AT, Douglas N. Comparison of nose and face mask CPAP therapy for sleep apnea. Thorax. 1998; 53 (4): 290-292.
Nilius G, Happel A, Domanski U, et al. Pressure relief continuous positive airway pressure vs. constant continuous positive airway pressure: a comparison of efficacy and compliance. Chest. 2006; 130 (4): 1018-1024.
Chodwuri S. Continuous positive airway pressure for the treatment of Sleep Apnea. Otolaryngol Clin N Am. 2007; 40: 807-827.
AASM Standards of practice Committee. Practice parameters for the use of auto titrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep
apnea syndrome. An American Academy of Sleep Medicine report. Sleep. 2002; 25 (2): 148-173.
Young T, Bluestein J, Finn L, et al. Sleep-disordered breathing and motor vehicle accidents in a population based-sample of employed adults. Sleep. 1997; 20 (8): 608-513.
Pepin JL, Leger P, Veale D, et al. Side effects of nasal continuous positive airway pressures in sleep apnea syndrome. Study of 193 patients in two French sleep centers. Chest. 1995; 10 (2): 375-381.
Hannifa M, Lasserson TJ, Smith I. Interventions to improve compliance with continuous positive airway pressures for obstructive sleep apnea. Cochrane Database Syst Rev. 2004 Oct 18; (4).
Lipton AJ, Gozal D. Treatment of obstructive sleep apnea in children:do we really know how? Sleep Medicine Review. 2003; 7 (1): 61 80.
Mc Ardle N, Devereux G, Heidarnejad H, et al. Long term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med. 1999; 159 (4 Pt 1): 1108-1114.
Baltzan MA, Kassissia I, Elkholi O, et al. Prevalence of persistent sleep apnea in patients treated with continuous positive airway pressure. Sleep. 2006; 29 (4): 557-563.
Sin D, Logan AG, Fitzgerald FS, et al. Effects of continuous positive airway pressure on cardiovascular outcomes in heart failure patients with and without Cheyne-Stokes respiration. Circulation. 2002; 102: 61-66.
Dhillon S, Chung SA, Fargher T, Huterer N, Shapiro CM. Sleep apnea, hypertension, and the effects of continuous positive airway pressure. Am J Hypertens. 2005; 18: 594-600.
Pepperell JC, Davies RJ, Stradling JR. Systemic hypertension and obstructive sleep apnea. Sleep Med Rev. 2002; 6: 157-173.
Duchna HW, Orth M, Schultze-Werninghaus G, Guilleminault C, Stoohs RA. Long-term effects of nasal continuous positive airway pressure on vaso-dilatory endothelial function in obstructive sleep apnea syndrome. Sleep Breath. 2005; 9: 97-.
Hoffstein V, Viner S, Matelka S, Conway J. Treatment of Obstructive Sleep apnea with Nasal Continuous Positive airway Pressure: Patient Compliance, perception of benefits and side effects. American Review Respiratory Disorders. 1992; 146: 841-845.
Edinger JD, Radtke RA. Use of In vivo desensitization to treat a patient’s claustrophobic response to nasal CPAP. Sleep. 1993; 16 (7): 678-680.
Stepnowsky CJ, Jr, Moore PJ. Improving CPAP use by patients with the sleep apnea/hypopnoea syndrome (SAHS). Sleep Med Rev. 2003; 7: 445-446.
Meslier N, Lebrun T, Grillier-Lanoir V, Rolland N, Henderick C, Sailly JC, et al. A French survey of 3,225 patients treated with CPAP for obstructive sleep apnea: benefits, tolerance, compliance and quality of life. Eur Respir J. 1998; 12: 185-192.
Sanders MH, Strollo PJ, Stiller RA. Positive Airway Pressure in the Treatment of Sleep-Related Breathing Disorders. In: Chokroverty S. Sleep Disorders Medicine: Basic Science, Technical Considerations, and Clinical Aspects. 2nd ed. Boston: Butterworth-Heinemann. 1999; 355-384
Kribbs NB, Pack Al, Kline LR, Smith PL, Schwartz AR, Schubert NM et al. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis. 1993; 147:
-895.
Meslier N, Lebrun T, Grillier-Lanoir V, Rolland N, Henderick C, Sailly JC, et al. A French survey of 3,225 patients treated with CPAP for obstructive sleep apnea: benefits, tolerance, compliance and quality of life. Eur Respir J. 1998; 12: 185-192.
Stepnowsky CJ, Jr, Moore PJ. Improving CPAP use by patients with the sleep apnea/hypopnea syndrome (SAHS). Sleep Med Rev. 2003; 7: 445-446.
Hoy CJ, Vennelle M, Kingshott RN, Engleman HM, Douglas NJ. Can intensive support improve continuous positive airway pressure use in patients with the sleep apnea/hypopnea syndrome? Am J Respir Crit Care Med. 1999; 159: 1096-1100.
Chervin RD, Theut S, Bassetti C, Aldrich M. Compliance with nasal CPAP can be improved simple interventions. Sleep. 1997; 20: 284- 289.
Wiese JH, Boethel C, Phillips B, Wilson JF, Peters J, Viggiano T. CPAP compliance: video education may help. Sleep Med. 2005; 6: 171-174.