Study objectives: For a subpopulation of children with obstructive sleep apnea, the mainstay of treatment is nasal continuous positive airway pressure (nCPAP). Accurate measures of "time in use" have not been used to assess compliance with nCPAP in large numbers of children. Data from a comprehensive nCPAP program are used to describe nCPAP use among children aged 6 months to 18 years and provide time-in-use compliance rates.
Design: Retrospective cohort study
Setting: University Pediatric Teaching Hospital
Interventions: Initiation of nCPAP treatment
Measurements and results: Seventy-nine children were identified as requiring treatment with nCPAP, with 65 (82%) successfully established on nCPAP during the 46-month study period. Objective compliance data were available on 50 children: 66% were boys, 78% had a complicating medical disorder, the mean age was 10 +/- 5.1 years, and the median apnea-hypopnea index was 11.3 (interquartile range, 5.4-25.9). Follow-up ranged from 8 to 979 days. Forty-eight percent of children used nCPAP immediately. Seventy-six percent of children used nCPAP for at least half the days, with use defined as 1 or more hours of recording during a 24-hour period. Mean daily use was 4.7 hours (interquartile range, 1.4-7.0), and mean daily use on days nCPAP was used was 6.3 hours (interquartile range, 3.3-8.5)
Conclusions: With patience, a behavioral modification approach, and parental commitment, children will be accepting of nCPAP and reasonably compliant with treatment.