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Continuous Positive Airway Pressure Used by Adults With Obstructive Sleep Apneas After Prescription in a Public Referral Hospital in Mexico City
Luis Torre Bouscoulet
, Elodia López Escárcega, Armando Castorena Maldonado, Juan Carlos Vázquez García, María Sonia Meza Vargas, Rogelio Pérez-Padilla
Corresponding author
luistorreb2001@yahoo.com.mx
Correspondence: Dr. L. Torre Bouscoulet. Clínica de Trastornos Respiratorios del Dormir. Instituto Nacional de Enfermedades Respiratorias. Tlalpán, 4.502. Colonia Sección XVI. Delegación Tlalpán. 14080 México DF. México
Correspondence: Dr. L. Torre Bouscoulet. Clínica de Trastornos Respiratorios del Dormir. Instituto Nacional de Enfermedades Respiratorias. Tlalpán, 4.502. Colonia Sección XVI. Delegación Tlalpán. 14080 México DF. México
Clínica de Trastornos Respiratorios del Dormir, Instituto Nacional de Enfermedades Respiratorias, Secretaría de Salud, México DF, Mexico
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Torre Bouscoulet. Clínica de Trastornos Respiratorios del Dormir. Instituto Nacional de Enfermedades Respiratorias. Tlalpán, 4.502. Colonia Sección XVI. Delegación Tlalpán. 14080 México DF. México" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-10-24" "fechaAceptado" => "2006-03-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154574" "palabras" => array:6 [ 0 => "Obstructive sleep apnea syndrome (OSAS)" 1 => "Apnea" 2 => "Therapeutics" 3 => "Sleep" 4 => "Continuous positive airway pressure (CPAP)" 5 => "Compliance" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154573" "palabras" => array:6 [ 0 => "SAOS" 1 => "Apnea" 2 => "Tratamiento" 3 => "Sueño" 4 => "CPAP" 5 => "Cumplimiento" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to analyze the frequency of initiation of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea syndrome (OSAS) in a referral hospital in Mexico City serving mainly patients without public health insurance coverage and to assess their level of adherence.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Patients with OSAS diagnosed by polysomnography or by simplified respiratory polygraphy for whom nasal CPAP was prescribed were enrolled in the study. Titration of CPAP was performed during polysomnography or with an automatic CPAP device. Compliance with treatment was assessed during a medical visit or by telephone interview.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 304 patients were enrolled upon prescription of nasal CPAP; 169 (55.5%) either purchased a device or were provided with one by the social security system. The patients most seriously ill and who had public health insurance coverage were the ones who most often acquired a device. These patients took 1.5 months to obtain the equipment and had a compliance rate of 80% at a mean 34 months of follow-up. The respiratory events index was correlated with compliance, whereas excessive daytime sleepiness (Epworth scale score) and body mass index were predictors of therapeutic CPAP pressure.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Nearly half the patients who were prescribed CPAP did not acquire the device. Most of those who acquired a device adhered to the treatment. In Mexico access to procedures for diagnosing OSAS is limited and access to treatment is also restricted for patients who do not have public health insurance coverage.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">El propósito del estudio ha sido analizar la fre-cuencia de inicio de tratamiento con presión positiva continua de la vía aérea (CPAP) y su cumplimiento en pacientes con síndrome de apneas obstructivas durante el sueño (SAOS), en un hospital de referencia de la Ciudad de México que atiende predominantemente a pacientes sin seguridad social.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluyó a pacientes con SAOS diagnosticados por poliomnografía o poligrafía respiratoria simplificada, a quienes se prescribió CPAP nasal. La titula-ción de ésta se realizó durante la polisomnografía o con un equipo automático de CPAP. El cumplimiento del tratamiento se evaluó en consulta o por entrevista telefónica.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluyó a un total de 304 pacientes con prescripción de CPAP nasal. De ellos, 169 (55,5%) adquirie-ron el equipo (ya fuera por compra o gratuitamente a través de la seguridad social). Los pacientes más graves y con seguridad social fueron los que más frecuentemente lo adquirie-ron. Este grupo tardó 1,5 meses en obtener el equipo y tuvo un 80% de cumplimiento a los 34 meses de seguimiento medio. El índice respiratorio se asoció al cumplimiento, mien-tras que la somnolencia diurna excesiva (puntuación de Epworth) y el índice de masa corporal fueron predictores de la presión terapéutica de CPAP.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Casi la mitad de los pacientes a quienes se prescribió CPAP no adquirió el equipo. La mayoría de quienes lo adquirieron cumplió el tratamiento. En México, ade-más del limitado acceso a los métodos diagnósticos de SAOS, el tratamiento está restringido en los pacientes diagnosticados que carecen de seguridad social.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Indications for positive airway pressure treatment of adult obstructive sleep apnea patients: a consensus statement" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "DI Loube" 1 => "PC Gay" 2 => "KP Strohl" 3 => "AI Pack" 4 => "DP White" 5 => "NA Collop" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1999" "volumen" => "115" "paginaInicial" => "863" "paginaFinal" => "866" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10084504" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mortality in severe sleep apnoea/hypopnoea syndrome patients: impact of treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S Marti" 1 => "G Sampol" 2 => "X Muñoz" 3 => "F Torres" 4 => "A Roca" 5 => "P Lloberes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2002" "volumen" => "20" "paginaInicial" => "1511" "paginaFinal" => "1518" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12503712" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Health-related quality of life in patients with obstructive sleep apnea: effects of long-term positive airway pressure treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F Pichel" 1 => "C Zamarrón" 2 => "F Magan" 3 => "F del Campo" 4 => "R Álvarez-Sala" 5 => "JR Suárez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "2004" "volumen" => "98" "paginaInicial" => "968" "paginaFinal" => "976" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15481273" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "NB Kribbs" 1 => "AI Pack" 2 => "LR Kline" 3 => "PL Smith" 4 => "AR Schwartz" 5 => "NM Schubert" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm/147.4.887" "Revista" => array:7 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1993" "volumen" => "147" "paginaInicial" => "887" "paginaFinal" => "895" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8466125" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109703006454" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effective compliance during the first 3 months of continuous positive airway pressure. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 1 | 3 | 4 |
| 2024 October | 34 | 17 | 51 |
| 2024 September | 31 | 18 | 49 |
| 2024 August | 46 | 41 | 87 |
| 2024 July | 19 | 21 | 40 |
| 2024 June | 30 | 33 | 63 |
| 2024 May | 36 | 39 | 75 |
| 2024 April | 14 | 27 | 41 |
| 2024 March | 24 | 16 | 40 |
| 2024 February | 18 | 18 | 36 |
| 2023 March | 3 | 0 | 3 |
| 2023 February | 10 | 20 | 30 |
| 2023 January | 21 | 23 | 44 |
| 2022 December | 24 | 27 | 51 |
| 2022 November | 17 | 20 | 37 |
| 2022 October | 23 | 38 | 61 |
| 2022 September | 22 | 26 | 48 |
| 2022 August | 17 | 41 | 58 |
| 2022 July | 21 | 38 | 59 |
| 2022 June | 20 | 38 | 58 |
| 2022 May | 22 | 27 | 49 |
| 2022 April | 18 | 29 | 47 |
| 2022 March | 17 | 36 | 53 |
| 2022 February | 20 | 24 | 44 |
| 2022 January | 19 | 37 | 56 |
| 2021 December | 15 | 52 | 67 |
| 2021 November | 22 | 45 | 67 |
| 2021 October | 19 | 48 | 67 |
| 2021 September | 11 | 56 | 67 |
| 2021 August | 14 | 27 | 41 |
| 2021 July | 9 | 30 | 39 |
| 2021 June | 47 | 39 | 86 |
| 2021 May | 28 | 27 | 55 |
| 2021 April | 34 | 69 | 103 |
| 2021 March | 28 | 26 | 54 |
| 2021 February | 19 | 26 | 45 |
| 2021 January | 17 | 12 | 29 |
| 2020 December | 16 | 9 | 25 |
| 2020 November | 16 | 14 | 30 |
| 2020 October | 11 | 11 | 22 |
| 2020 September | 5 | 4 | 9 |
| 2020 August | 16 | 11 | 27 |
| 2020 July | 9 | 18 | 27 |
| 2020 June | 7 | 8 | 15 |
| 2020 May | 18 | 17 | 35 |
| 2020 April | 12 | 21 | 33 |
| 2020 March | 13 | 11 | 24 |
| 2020 February | 13 | 14 | 27 |
| 2020 January | 19 | 13 | 32 |
| 2019 December | 18 | 6 | 24 |
| 2019 November | 8 | 11 | 19 |
| 2019 October | 7 | 3 | 10 |
| 2019 September | 11 | 10 | 21 |
| 2019 August | 8 | 3 | 11 |
| 2019 July | 7 | 13 | 20 |
| 2019 June | 7 | 8 | 15 |
| 2019 May | 16 | 6 | 22 |
| 2019 April | 18 | 9 | 27 |
| 2019 March | 11 | 12 | 23 |
| 2019 February | 10 | 10 | 20 |
| 2019 January | 11 | 10 | 21 |
| 2018 December | 5 | 13 | 18 |
| 2018 November | 20 | 11 | 31 |
| 2018 October | 14 | 13 | 27 |
| 2018 September | 9 | 8 | 17 |
| 2018 May | 5 | 0 | 5 |
| 2018 April | 7 | 4 | 11 |
| 2018 March | 3 | 2 | 5 |
| 2018 February | 6 | 11 | 17 |
| 2018 January | 2 | 6 | 8 |
| 2017 December | 3 | 4 | 7 |
| 2017 November | 5 | 3 | 8 |
| 2017 October | 3 | 6 | 9 |
| 2017 September | 6 | 5 | 11 |
| 2017 August | 6 | 7 | 13 |
| 2017 July | 3 | 2 | 5 |
| 2017 June | 7 | 8 | 15 |
| 2017 May | 5 | 5 | 10 |
| 2017 April | 2 | 1 | 3 |
| 2017 March | 7 | 0 | 7 |
| 2017 February | 0 | 2 | 2 |
| 2017 January | 2 | 0 | 2 |
| 2016 December | 7 | 2 | 9 |
| 2016 November | 15 | 11 | 26 |
| 2016 October | 13 | 4 | 17 |
| 2016 September | 5 | 5 | 10 |
| 2016 August | 5 | 6 | 11 |
| 2016 July | 1 | 4 | 5 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 3 | 0 | 3 |
| 2015 December | 4 | 0 | 4 |
| 2015 October | 40 | 6 | 46 |
| 2015 September | 82 | 7 | 89 |
| 2015 August | 32 | 5 | 37 |
| 2015 July | 44 | 7 | 51 |
| 2015 June | 27 | 3 | 30 |
| 2015 May | 36 | 6 | 42 |
| 2015 April | 33 | 5 | 38 |
| 2015 March | 33 | 5 | 38 |
| 2015 February | 44 | 4 | 48 |
| 2015 January | 41 | 3 | 44 |
| 2014 December | 31 | 6 | 37 |
| 2014 November | 37 | 5 | 42 |
| 2014 October | 53 | 10 | 63 |
| 2014 September | 44 | 4 | 48 |
| 2014 August | 43 | 11 | 54 |
| 2014 July | 44 | 6 | 50 |
| 2014 June | 56 | 5 | 61 |
| 2014 May | 60 | 8 | 68 |
| 2014 April | 48 | 9 | 57 |
| 2014 March | 59 | 6 | 65 |
| 2014 February | 62 | 9 | 71 |
| 2014 January | 39 | 7 | 46 |
| 2013 December | 52 | 7 | 59 |
| 2013 November | 30 | 4 | 34 |
| 2013 October | 39 | 5 | 44 |
| 2013 September | 35 | 9 | 44 |
| 2013 August | 57 | 6 | 63 |
| 2013 July | 44 | 7 | 51 |
| 2013 June | 34 | 10 | 44 |
| 2013 May | 31 | 4 | 35 |
| 2013 April | 23 | 3 | 26 |
| 2013 March | 8 | 2 | 10 |
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