ADHERENCE TO CONTINUOUS POSITIVE AIRWAY PRESSURE THERAPY IN PEDIATRIC PATIENTS WITH OBSTRUCTIVE SLEEP APNEA: A META-ANALYSIS
Introduction - Obstructive sleep apnea (OSA) is a public health problem that affects children. Although continuous positive airway pressure (CPAP) therapy is effective, the CPAP adherence rate in children is varied. This study aimed to evaluate the overall CPAP adherence rate and factors associated with CPAP adherence in children with OSA using a meta-analysis method and calculation.
Methods: This study examined factors associated with CPAP adherence in children with OSA. The inclusion criteria were studies conducted in children with OSA and assessed adherence of CPAP using objective evaluation. The literature search was performed in four databases. Predictors for CPAP adherence were executed.
Results: In all, 34 studies that evaluated adherence rate and predictors of CPAP adherence in children with OSA were included, representing 22,075 patients with an average adherence rate of 47.19%. There were 11 calculations of factors predictive of CPAP adherence: age, sex, ethnicity, body mass index, obesity, income, sleep efficiency, the apnea-hypopnea index (AHI), severity of OSA, residual AHI, and lowest oxygen saturation level. Three different factors were linked to children with adherence and non-adherence to CPAP: age, body mass index, and AHI.
Conclusions: Young age, low body mass index, and high AHI were associated with acceptable CPAP adherence in children with OSA.