Long-term adherence to ambulatory initiated continuous positive airway pressure in non-syndromic OSA children

Purpose In children, the usual indications for continuous positive airway pressure (CPAP) are residual OSA after adenotonsillectomy and/or persistent OSA due to obesity. Data concerning adherence (hours/night) following ambulatory CPAP initiation are scarce. Methods An observational cohort of 78 children was followed over 2years. All exhibited sleep-disordered breathing (SDB) symptoms, were assessed by polysomnography, and prescribed CPAP. CPAP was initiated at hospital for 10 children. Results OSA children, mean age 10.43.2years, were mostly males (75.6%), with a mean body mass index of 21.2 +/- 7.3kg/m(2), and mean apnea+hypopnea index of 12.2 +/- 10.6 events/hour. Seventy-two children were still on CPAP at 3months, 63 at 6months, 55 at 1year, and 34 at 2years. CPAP was discontinued thanks to rehabilitation programs, dento-facial orthopedics, and/or weight loss. Mean CPAP adherence at 1, 3, 6, 12, and 24months was respectively 6.1 +/- 2.8, 6.2 +/- 2.6, 6.2 +/- 2.8, 6.3 +/- 2.8, and 7.0 +/- 2.7h/night. There was a trend towards higher CPAP adherence and younger age, primary versus middle/high school attendance, higher baseline apnea+hypopnea index, and neurocognitive disorders. Conclusion In our population, mean CPAP adherence defined in hours per night was high and did not decrease during the 24-month follow-up. These findings support the feasibility of ambulatory CPAP initiation in non-syndromic OSA. The high CPAP adherence is expected to be associated with improvements in neurocognition, and in metabolic and cardiovascular parameters.