Feasibility and Long-Term Compliance to Continuous Positive Airway Pressure Treatment in Adults With Down Syndrome, a Genetic Form of Alzheimer's Disease
Por:
Gimenez, S, Farré A, Morente, F, Videla, L, Gutierrez, M, Clos, S, Fernandez, A, Blanco, M, Altuna, M, Pegueroles, J, Asensio, A, Benejam, B, Batista, M, Barroeta, I, Fortuna, A, Fortea, J, Mayos, M
Publicada:
30 mar 2022
Resumen:
BackgroundDown syndrome (DS) is a genetic form of Alzheimer's disease (AD) with a high prevalence of obstructive sleep apnea (OSA). These characteristics place the DS population as an optimal model to study the relationship between sleep and AD and to design clinical trials of preventive sleep therapies for AD. Regrettably, OSA treatment with continuous positive airway pressure (CPAP) is often neglected in adults with DS. In both clinical practice and research trials, it is usually presumed that these patients will not adapt to or tolerate the therapy. Study ObjectiveWe aimed to evaluate the feasibility and long-term CPAP compliance in this population and their capacity to be enrolled in CPAP research studies. MethodsWe prospectively compared the CPAP compliance of 17 OSA patients with DS and 19 age and sex matched OSA euploid patients. CPAP management and follow-up schedules were prescribed according to the habitual clinical practice. We compared group differences in tolerance, objective, and subjective hours of nightly CPAP usage at the 1st, 3rd, 6th, 12th, 24th, and 36th month visits. Good compliance was defined as at least 4 h use per night. We also investigated predictive factors of long-term CPAP compliance. ResultsThe percentage of DS subjects with good CPAP compliance (81.2 vs. 78.9%) and the objective CPAP use (5 vs. 6 h, p = 0.92) did not differ from the control group (CG). Subjective CPAP compliance was significantly higher in OSA patients with DS than in controls in all the follow-up visits (8 vs. 6.75 h, p = 0.001). The DS group had a significantly higher number of visits (9 vs. 5; p = 0.021) and mask changes (2.5 vs. 2; p = 0.05) than controls. Objective hours of CPAP use at the first follow-up visit predicted long-term CPAP compliance (p < 0.005). ConclusionCPAP treatment is feasible and has good long-term compliance in OSA patients with DS. It should be recommended to improve health and prevent comorbidities. The DS population is indeed suitable to participate in longitudinal preventive sleep clinical trials for AD.
Filiaciones:
Gimenez, S:
Hosp Santa Creu & Sant Pau, Multidisciplinary Sleep Unit, Resp Dept, Biomed Res Inst St Pau, Barcelona, Spain
Farré A:
Hosp Santa Creu & Sant Pau, Multidisciplinary Sleep Unit, Resp Dept, Biomed Res Inst St Pau, Barcelona, Spain
Morente, F:
Hosp Santa Creu & Sant Pau, Multidisciplinary Sleep Unit, Resp Dept, Biomed Res Inst St Pau, Barcelona, Spain
Videla, L:
Univ Autonoma Barcelona, Dept Neurol, St Pau Memory Unit, Hosp Santa Creu & St Pau,Biomed Res Inst St Pau, Barcelona, Spain
Ctr Biomed Invest Network Neurodegenerat Dis CIBE, Madrid, Spain
Fundacio Catalana Sindrome Down, Barcelona Down Med Ctr, Barcelona, Spain
Gutierrez, M:
Hosp Santa Creu & Sant Pau, Multidisciplinary Sleep Unit, Resp Dept, Biomed Res Inst St Pau, Barcelona, Spain
Clos, S:
Univ Autonoma Barcelona, Dept Neurol, St Pau Memory Unit, Hosp Santa Creu & St Pau,Biomed Res Inst St Pau, Barcelona, Spain
Fernandez, A:
Hosp Santa Creu & Sant Pau, Multidisciplinary Sleep Unit, Resp Dept, Biomed Res Inst St Pau, Barcelona, Spain
Blanco, M:
Hosp Santa Creu & Sant Pau, Multidisciplinary Sleep Unit, Resp Dept, Biomed Res Inst St Pau, Barcelona, Spain
Altuna, M:
Univ Autonoma Barcelona, Dept Neurol, St Pau Memory Unit, Hosp Santa Creu & St Pau,Biomed Res Inst St Pau, Barcelona, Spain
Ctr Biomed Invest Network Neurodegenerat Dis CIBE, Madrid, Spain
Pegueroles, J:
Univ Autonoma Barcelona, Dept Neurol, St Pau Memory Unit, Hosp Santa Creu & St Pau,Biomed Res Inst St Pau, Barcelona, Spain
Asensio, A:
Hosp Santa Creu & Sant Pau, Multidisciplinary Sleep Unit, Resp Dept, Biomed Res Inst St Pau, Barcelona, Spain
Benejam, B:
Univ Autonoma Barcelona, Dept Neurol, St Pau Memory Unit, Hosp Santa Creu & St Pau,Biomed Res Inst St Pau, Barcelona, Spain
Ctr Biomed Invest Network Neurodegenerat Dis CIBE, Madrid, Spain
Fundacio Catalana Sindrome Down, Barcelona Down Med Ctr, Barcelona, Spain
Batista, M:
Hosp Santa Creu & Sant Pau, Multidisciplinary Sleep Unit, Resp Dept, Biomed Res Inst St Pau, Barcelona, Spain
Barroeta, I:
Univ Autonoma Barcelona, Dept Neurol, St Pau Memory Unit, Hosp Santa Creu & St Pau,Biomed Res Inst St Pau, Barcelona, Spain
Ctr Biomed Invest Network Neurodegenerat Dis CIBE, Madrid, Spain
Fortuna, A:
Hosp Santa Creu & Sant Pau, Multidisciplinary Sleep Unit, Resp Dept, Biomed Res Inst St Pau, Barcelona, Spain
Fortea, J:
Univ Autonoma Barcelona, Dept Neurol, St Pau Memory Unit, Hosp Santa Creu & St Pau,Biomed Res Inst St Pau, Barcelona, Spain
Ctr Biomed Invest Network Neurodegenerat Dis CIBE, Madrid, Spain
Fundacio Catalana Sindrome Down, Barcelona Down Med Ctr, Barcelona, Spain
Mayos, M:
Hosp Santa Creu & Sant Pau, Multidisciplinary Sleep Unit, Resp Dept, Biomed Res Inst St Pau, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Resp CIBERNED, Madrid, Spain
gold, Green Published, All Open Access, Gold, Green
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