Educational video demonstrating collapsibility of the upper airway during sleep improves initial acceptance of CPAP in patients with severe obstructive sleep apnea: a retrospective study

Charikleia Tselepi; Georgios Tsirves; Konstantinos Exarhos; Christos Chronis; Christos Kyriakopoulos; Konstantinos Tatsis; Konstantinos Kostikas; Athanasios Konstantinidis

doi:10.5664/jcsm.11166

Educational video demonstrating collapsibility of the upper airway during sleep improves initial acceptance of CPAP in patients with severe obstructive sleep apnea: a retrospective study

J Clin Sleep Med. 2024 Apr 22. doi: 10.5664/jcsm.11166. Online ahead of print.

Authors

Charikleia Tselepi¹, Georgios Tsirves², Konstantinos Exarhos³, Christos Chronis³, Christos Kyriakopoulos³, Konstantinos Tatsis³, Konstantinos Kostikas³, Athanasios Konstantinidis¹

Affiliations

¹ Sleep Disorders Unit, Department of Respiratory Medicine, University Hospital of Ioannina, Ioannina, Greece.
² Department of ENT, University Hospital of Ioannina, Ioannina, Greece.
³ Department of Respiratory Medicine, University Hospital of Ioannina, Ioannina, Greece.

PMID: 38648113
DOI: 10.5664/jcsm.11166

Abstract

Study objectives: To investigate if an audio-visual educational video demonstrating collapsibility of the upper airway during sleep influences initial CPAP acceptance among patients with severe obstructive sleep apnea (OSA).

Methods: Between January 2017 and December 2018, a single-center retrospective study was conducted. We implemented an educational video demonstrating upper airway collapsibility during sleep in February 2018. We analyzed the medical records from 145 consecutive patients diagnosed with severe OSA who underwent in-lab polysomnography (PSG) both before and after implementing the educational video. Among them, 76 patients received standard care before the video's introduction (standard care group), and another 69 patients were managed after its implementation (video group).

Results: Baseline characteristics including age, BMI, educational level, occupation category, comorbidities, Mallampati score, Epworth Sleepiness Scale (ESS) score, apnea hypopnea index (AHI) and sleep time with SpO₂ below 90% (T90%) were not significantly different between the two groups. Acceptance of CPAP following in-lab overnight titration study was significantly higher in the video group (80%) compared to the standard care group (57%), P= .004.

Multivariate regression analyses revealed that watching the video was a strong predictor of initial CPAP acceptance (OR 4.162, 95%, CI 1.627-10.646; P= .004). Both T90% (OR 1.020 95% CI 1.002 to 1.038; P= .029) and sleep efficiency (OR 1.052 95% CI 1.023 to 1.083; P< .001) were weak predictors for initial CPAP acceptance. At 12 months, adherence among those who accepted the CPAP treatment was similar between the two groups (78% vs 74%, P= .662). However, within the initial cohorts, a significantly higher proportion of patients in the video group (62%) were using CPAP at 12 months compared to the standard care group (42%), P= .015.

Conclusions: Among patients with severe OSA, an educational video demonstrating upper airway collapsibility during sleep improved initial CPAP acceptance rates when compared to standard care.

Keywords: CPAP acceptance; CPAP adherence; CPAP rejection; OSA; educational videos; educational videos in OSA; improving CPAP adherence; interventions to improve CPAP acceptance; interventions to improve CPAP adherence; interventions to improve usage of CPAP.