Acceptance of Telemonitoring Among Patients with Obstructive Sleep Apnea Syndrome: How is the Perceived Interest by and for Patients?

International audienc

Driving ability in sleep apnoea patients before and after CPAP treatment: evaluation on a road safety platform.

International audienceSleepiness is considered to be the major cause of increased traffic accidents in patients with obstructive sleep apnoea syndrome (OSAS). Until now, OSAS patients' driving ability has been assessed using driving simulators, but no assessment in a more natural driving environment has been carried out to date. The aim of the present study was to evaluate driving parameters in OSAS and in controls on a road safety platform, and to compare them with attentional in-laboratory measures before and after continuous positive airway pressure treatment. The parameters measured were: reaction time; distance to stop and number of collisions on the platform; maintenance of wakefulness; and sustained, selective and divided attention in laboratory. Patients exhibited much longer reaction times than controls, leading to a lengthening of the vehicle's stopping distance of 8.8 m at 40 km.h(-1) and to twice the number of collisions. Patients did not demonstrate objective sleepiness or selective and sustained attention deficits. Divided attention deficits were found. However, they did not allow the prediction of real driving impairment. After CPAP treatment, there was no longer any difference between patients and controls regarding driving and attention performances. Driving abilities are significantly impaired in obstructive sleep apnoea syndrome. After continuous positive airway pressure treatment, deficits were normalised. This stresses the importance of evaluating attentional parameters in apnoeic patients and of offering continuous positive airway pressure treatment even to non-sleepy subjects

Determination of risks of lower adherence to CPAP treatment before their first use by patients

International audienceA better understanding of Continuous Positive Airway Pressure (CPAP) adherence is a priority in improving patient care. To Identify adherence typology with a longitudinal approach, and explore the early determinants of lower adherence to CPAP. Obstructive sleep apnea patients ( N = 204). Prospective and longitudinal study.A classification into four profiles was observed: “ Regular Adherents,” “ Non-Regular Adherents,” “ Persistent Non-Adherents,” and “ Non-Persistent Non-Adherents.” Specific biopsychosocial factors make it possible to evaluate the risk of belonging to a lower adherence profile. We propose a novel approach of CPAP treatment adherence. Several pre-determinants have been identified

Nasal Obstruction Symptom Evaluation Score to Guide Mask Selection in CPAP-Treated Obstructive Sleep Apnea.

Nasal obstruction is frequently reported by patients with sleep apnea and complicates the choice of a nasal or oronasal mask for continuous positive airway pressure (CPAP) therapy. However, the type of interface used for the delivery of CPAP is crucial to ensure tolerance and compliance. The aim of this prospective pilot study was to identify whether the validated Nasal Obstruction Symptom Evaluation (NOSE) score rated at CPAP initiation was associated with the type of mask used after 4 months of treatment. Patients completed the NOSE questionnaire before initiation with automatic CPAP. The mask used (nasal/oronasal) after 4 months was documented. In total, 198 consecutive patients with sleep apnea were included. NOSE score (>50/100) was independently associated with the use of an oronasal mask at 4 months (sensitivity, 34.8%; specificity, 87.5%). The NOSE questionnaire could be a simple decision-making tool to guide the choice of mask during CPAP initiation

Peer-driven intervention to help patients resume CPAP therapy following discontinuation: a multicentre, randomised clinical trial with patient involvement

International audienceIntroduction Obstructive sleep apnoea syndrome (OSAS) is one of the most common chronic diseases. It may be associated with symptoms of excessive daytime sleepiness and neurocognitive and cardiovascular complications. First line therapy for OSAS involves home continuous positive airway pressure (CPAP), however, nearly half of patients do not adhere with this treatment over the long term. Cognitive-behavioural interventions that include health professionals and patient and public involvement are increasingly advocated in the fields of education and research. We hypothesise that a peer-driven intervention could help patients with OSAS to resume CPAP use after discontinuation. Methods and analysis We have designed a prospective, multicentre randomised, controlled trial that will be coconducted by health professionals, a home provider of CPAP and patients as experts or peers or participants. The primary aim is to evaluate the impact of a 6-month, peer-driven intervention to promote the resumption of CPAP after discontinuation. We anticipate that 20% of patients in the intervention group will reuse CPAP as compared with 6% in control group, thus, 104 patients must be included in each group. The secondary aims are (1) to evaluate the impact of the peer-driven intervention on adherence to CPAP compared with the control group (mean adherence and percentage of nights with at least 4 hours’ use/night for 70% of nights); (2) to determine factors associated with resumption of CPAP; (3) to assess patient satisfaction with the peer-driven intervention at 6 months; (4) to evaluate the feasibility and the execution of the peer-driven intervention and peer satisfaction. Adult outpatients with an established diagnosis of severe OSA (Apnoea-Hypopnoea Index >30 events/hour) that have stopped using CPAP within 4–12 months after initiation will be recruited. The peers who will perform the intervention will be patients with OSAS treated with CPAP with good adherence (at least 4 hours/night, 70% of nights) and trained in motivational enhancement and cognitive-behavioural therapies. Trained peers will conduct three interviews within 6 months with participants. Ethics and dissemination Ethical approval has been obtained from the French Regional Ethics Committee CPP Ouest II-Angers, (IRB 21.02.25.68606 (2021/2025)). All participants will sign written informed consent. The results will be presented at conferences and published in peer-reviewed journals as well as public media. Trial registration number NCT0453827