Patterns of Continuous Positive Airway Pressure Adherence during the First 3 Months of Treatment in Children

Objective To determine predictors of continuous airway pressure (CPAP) adherence in children. Study design Analysis of CPAP usage data for children between 2004 and 2008. Results During the study period, 32 children were prescribed CPAP; 2 failed to accept the mask, and 30 (mean +/- SD age 9.1 +/- 5.3 years) were included in further analysis. In the first 2 to 3 months of treatment, average (+/- SD) CPAP use was 4.7 +/- 2.7 hours/night. Hours of use were not affected by age, sex, baseline obstructive apneahypopnea index, intellectual disability, or socioeconomic status (P > .05). Of the children, 10 (33%) used CPAP for one hour or more on more than 6 nights per week and were defined as consistent users. Consistent users treated with CPAP for significantly longer on nights of use than intermittent users (7.2 +/- 2.0 hours vs 4.7 +/- 2.4 hours, P = .008). The hours of use differed between the two groups after the second night of treatment (P < .05), and this difference persisted for the first 3 months of therapy. Conclusions Children who attempted to use CPAP at least 6 nights a week were treated with CPAP for a longer time on the nights of use. Usage in the first week of treatment predicted longer term use over 2 to 3 months. Monitoring adherence in the first week of treatment and intervening in cases of low adherence may improve long-term CPAP use. (J Pediatr 2011;159:802-7).