Compliance to non-invasive continuous positive airway pressure ventilation in children with obstructive sleep apnoea

Introduction: Continuous Positive Airway Pressure (CPAP) can be used effectively to treat Obstructive Sleep Apnoea (OSA) in children. Discrepancies are often seen between subjective and objective compliance to CPAP therapy. Aims: To determine the compliance to nocturnal CPAP use in children with OSA at a tertiary paediatric hospital in Singapore. Methods: We performed a cross sectional study on our cohort of children with OSA currently on treatment with CPAP and being followed up at the KK Women9s and Children9s Hospital, Singapore. CPAP was initiated in the outpatient setting with patient/carer education and interface fitting; and was followed by CPAP titration polysomnography. Demographics, clinical details and the downloaded data from the CPAP machine that includes the nightly CPAP usage hours were collected at the most recent clinic visit. Data on patients who reported to be completely non-compliant and on whom the CPAP machine data were not downloadable due to other reasons (e.g.; multiple default to clinic follow up appointments, CPAP machine models that do not allow data downloading), were not analyzed. Results: 26 children (mean age=14.6 [SD=4.8] years, 17 [65%] males) were studied. 5 (19%) children had Primary OSA. The remaining had co-morbities such as obesity (n=13, 50%), Trisomy 21 (n=4, 15%), craniofacial abnormalities (n=2, 8%) or others (n=2, 8%). Median [IQR] adherence to CPAP therapy was 5.76 [2.49-7.37] hours. Conclusions: Our patient group has comparable compliance to existing published data on CPAP compliance. Objective monitoring of CPAP compliance is important in the management of children with OSA.