Evaluating the effectiveness of patient education and the feasibility of health technology (eHealth interventions) in improving sleep quality and blood pressure secondary to greater adherence to continuous positive airway pressure ventilation in persons with obstructive sleep apnoea: A literature review (Preprint)

2021 ◽  
Author(s):  
Rabie El Arab
Keyword(s):  
Blood Pressure ◽  
Continuous Positive Airway Pressure ◽  
Patient Education ◽  
Sleep Quality ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sleep Apnoea ◽  
Cpap Adherence ◽  
Obstructive Sleep ◽  
Positive Airway Pressure Ventilation

UNSTRUCTURED Obstructive sleep apnoea is a highly burdensome condition that predominantly affects adults and not only impairs daily functioning but also confers a heightened risk of adverse cardiovascular health, particularly among those who are poorly compliant with continuous positive airway pressure ventilation therapy. In the growing era of high population demand and rising complexity, greater efforts are needed at the individual level if outcomes are to improve in the future. Therefore, this literature review sought to explore the effect of patient education upon sleep quality and blood pressure as secondary effects of CPAP adherence in adults. A search for relevant literature was performed using MEDLINE, EMBASE and the Cochrane library. Articles were restricted to peer-review, English language and publication in the last 10 years. Articles were appraised using CASP, relevant data was extracted using systematic proformas and the outcomes were analysed using descriptive analysis and narrative synthesis. Nine studies were included in the first analysis where there was a highly significant association between education provision and CPAP adherence (MD=1.19 hours/night, Z=3.67, p=0.0002), than compared to usual care. The second analysis was informed from five studies and this showed a positive association between education and sleep quality, but the effect was marginally insignificant (MD=0.54, Z=1.89, p=0.06), than compared to usual care. Both analyses were not affected by inter-study heterogeneity (both p<0.01). Overall, this review showed that the provision of education with moderate to high intensity provides meaningful effects upon CPAP adherence and sleep quality. Narrative findings also revealed improvements in blood pressure and other health outcomes, which are supported by previous studies. Despite some limitations, care providers should be proactivity in education provision using a continuous approach through the disease course as this is likely to lead to improvements in outcomes. Finally, future research is needed in the form of a high-quality randomised trial to help explore the effects of education delivered through eHealth mediums.

Evaluating the effectiveness of patient education and the feasibility of health technology (eHealth interventions) in improving sleep quality and blood pressure secondary to greater adherence to continuous positive airway pressure ventilation in persons with obstructive sleep apnoea: A literature review (Preprint)

2021 ◽  
Author(s):  
Rabie Adel Abdel-Kar El Arab
Keyword(s):  
Blood Pressure ◽  
Continuous Positive Airway Pressure ◽  
Patient Education ◽  
Sleep Quality ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sleep Apnoea ◽  
Cpap Adherence ◽  
Obstructive Sleep ◽  
Positive Airway Pressure Ventilation

UNSTRUCTURED Obstructive sleep apnoea is a highly burdensome condition that predominantly affects adults and not only impairs daily functioning but also confers a heightened risk of adverse cardiovascular health, particularly among those who are poorly compliant with continuous positive airway pressure ventilation therapy. In the growing era of high population demand and rising complexity, greater efforts are needed at the individual level if outcomes are to improve in the future. Therefore, this literature review sought to explore the effect of patient education upon sleep quality and blood pressure as secondary effects of CPAP adherence in adults. A search for relevant literature was performed using MEDLINE, EMBASE and the Cochrane library. Articles were restricted to peer-review, English language and publication in the last 10 years. Articles were appraised using CASP, relevant data was extracted using systematic proformas and the outcomes were analysed using descriptive analysis and narrative synthesis. Nine studies were included in the first analysis where there was a highly significant association between education provision and CPAP adherence (MD=1.19 hours/night, Z=3.67, p=0.0002), than compared to usual care. The second analysis was informed from five studies and this showed a positive association between education and sleep quality, but the effect was marginally insignificant (MD=0.54, Z=1.89, p=0.06), than compared to usual care. Both analyses were not affected by inter-study heterogeneity (both p<0.01). Overall, this review showed that the provision of education with moderate to high intensity provides meaningful effects upon CPAP adherence and sleep quality. Narrative findings also revealed improvements in blood pressure and other health outcomes, which are supported by previous studies. Despite some limitations, care providers should be proactivity in education provision using a continuous approach through the disease course as this is likely to lead to improvements in outcomes. Finally, future research is needed in the form of a high-quality randomised trial to help explore the effects of education delivered through eHealth mediums.

scholarly journals 0653 Positive Effects of Long Term Continuous Positive Airway Pressure Therapy on Blood Pressure in Obstructive Sleep Apnea Patients

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A249-A249
Author(s):  
R Shirahama ◽  
T Tanigawa ◽  
K Tomooka ◽  
L Fan Yun ◽  
A Ikeda ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Weight Loss ◽  
Obstructive Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Cpap Therapy ◽  
Significant Weight Loss ◽  
Cpap Adherence ◽  
Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is one of the common causes of hypertension. Therefore, we examine the longitudinal effect of continuous positive airway pressure (CPAP) therapy and its adherence on blood pressure among OSA patients. Methods One thousand two hundred ninety-three (male 1,130, female 163) patients, who were diagnosed with OSA and underwent CPAP therapy were investigated for longitudinal changes (24 months observation period) in the levels of blood pressure and body weight. The longitudinal analyses were performed by mixed effect model. Multiple Imputation with Chained Equations was also used to impute missing data. Good CPAP adherence is defined as more than 70% of the time using CPAP more than 4hours at all the measuring. Poor CPAP adherence is defined as less than 70% of the time using CPAP more than 4hours at all the measuring time points. Results The patient group with good CPAP adherences), compared to poor CPAP adherence, showed significant diastolic blood pressure reduction in 24 months follow-up period (β=-0.13, p=0.03) despite a lack of significant weight loss (β=-0.02, p=0.59). However, no significant associations were found between systolic blood pressure and CPAP adherence (β=-0.14, p=0.11). Conclusion CPAP therapy was found to have a longitudinal effect on diastolic blood pressure despite a lack of significant weight loss. Support  

scholarly journals Continuous positive airway pressure treatment for obstructive sleep apnoea: Maori, Pacific and New Zealand European experiences

2014 ◽  
Vol 6 (3) ◽  
pp. 221 ◽  
Author(s):  
Jessie Bakker ◽  
Karyn O’Keeffe ◽  
Alister Neill ◽  
Angela Campbell
Keyword(s):  
New Zealand ◽  
Continuous Positive Airway Pressure ◽  
Obstructive Sleep Apnoea ◽  
Role Models ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sleep Apnoea ◽  
Cpap Adherence ◽  
Cpap Treatment ◽  
Obstructive Sleep

INTRODUCTION: Continuous positive airway pressure (CPAP) is an effective treatment of obstructive sleep apnoea (OSA), but can be limited by poor adherence. In New Zealand (NZ), ethnicity has been shown to be a predictor of CPAP adherence. This study aimed to explore Maori, Pacific and NZ European patients’ experience of CPAP treatment. METHODS: Patients identifying as Maori, Pacific, or NZ European ethnicity referred for CPAP treatment for OSA attended separate, 1.5-hour group discussions facilitated by a health care worker of the same ethnic group, using an interview template. Thematic analysis was applied to the discussion transcripts independently by two investigators, following published guidelines. FINDINGS: Five Maori, five Pacific, and eight NZ Europeans participated (mean age 47, range 30–71 years, mean ± standard deviation CPAP adherence 6.32 ±1.25 hours/night). Patients in all three groups reported that they had little knowledge of OSA or CPAP prior to treatment initiation. All groups identified barriers to treatment (both at the CPAP initiation phase and long term), reported feelings of being ‘overwhelmed’ with information during the initial CPAP education session, and discussed the importance of successful role models. Family and friends were generally reported as being supportive of CPAP therapy. CONCLUSION: The three groups all reported similar initial CPAP experiences, highlighting access barriers to publicly funded assessment and treatment pathways, and sleep health knowledge as key issues. Educational resources to improve access, enable self-management, and increase community awareness of OSA would help overcome some of the issues identified in this study. KEYWORDS: Continuous positive airway pressure; obstructive sleep apnea; ethnic groups; focus groups

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