241202 Getting Patients to Comply with Their OSA Therapy
3 Contact Hours Examination
Select the best answer to each of the following items.
1. Forty-five percent of normal adults snore at least occasionally, and 25 percent are habitual snorers. Various methods are used to alleviate snoring and/or OSA. They include _______.
a. behavior modification
b. sleep positioning
c. Continuous Positive Airway Pressure (CPAP)
d. All of the above
2. Nasal CPAP delivers air into your airway through a specially designed nasal mask or pillows.
a. True
b. False
3. The mask “breathes” for you; the flow of air creates enough pressure when you inhale to keep your airway open.
4. CPAP is considered the most effective non-surgical treatment for the alleviation of snoring and obstructive sleep apnea.
5. CPAP compliance simply means that a patient is carrying out a prescribed treatment plan exactly as directed. In most cases, this will mean that their condition, disorder or disease is cured, or under control.
6. When patients don't comply with treatment, the consequences can be very negative for the patient. The patient continues suffering from the complex of OSA symptoms and complications that can include _______.
a. fatigue
b. confusion
c. falling asleep at inappropriate times
7. Obstructive sleep apnea-hypopnea syndrome (OSAHS) is characterized by repetitive episodes of airflow reduction (hypopnea) or cessation (apnea) due to upper airway collapse during sleep.
8. Obstructive sleep apnea-hypopnea syndrome (OSAHS) is characterized by repetitive episodes of airflow reduction due to pharyngeal narrowing, leading to acute gas exchange abnormalities and sleep fragmentation and resulting in neurobehavioral and cardiovascular consequences.
9. Large population-based studies have associated OSAHS with _______.
a. cardiovascular disease
b. cerebrovascular disease
c. increased mortality
10. Usage patterns and problems with CPAP vary among patients. The minimum effective CPAP use time is unknown, but improvements in objective daytime sleepiness have been shown when average use is less than 4 hours per night. Nightly versus intermittent (sub-optimal compliance) CPAP use patterns may be established within the first several weeks to one month.
11. CPAP therapy is often difficult to tolerate and patients frequently stop using it because of discomfort. The nasal mask interface may cause pressure sores, persistent air leakage, claustrophobia, nasal congestion, and other side effects that may lead to suboptimal compliance.One study suggested that CPAP compliance might be improved with intensive CPAP support, where these problems can be addressed through a multidisciplinary team approach.
12. There is now a universally accepted definition of CPAP compliance.
13. In a study cited in the course, with the application of and compliance with CPAP therapy, there was a marked improvement in the patients’ daytime sleepiness as measured by the ESS. In just 2 weeks following initiation of CPAP therapy, they observed a 44% relative reduction in the average daytime sleepiness for our cohort of patients.
14. Study findings suggest that high CPAP compliance rates are achievable in the community through a comprehensive CPAP program that provided free CPAP devices, extensive education, and follow-up services for symptomatic OSA patients with moderate-to-severe disease through a multidisciplinary team approach.
15. The lack of subjective benefit from CPAP appears to be a major factor having detrimental influences on adherence and compliance.
16. Good basic education and support are essential in ensuring good CPAP compliance.
17. Every effort should be made to minimize the side effects of CPAP in order to enhance the quality of patients’ lives and to increase the likelihood of compliance.
18. Many factors affect CPAP compliance, but education and support, rather than in-laboratory CPAP titration, appear to be pivotal. Self-adjustment of CPAP at home will provide equal or superior efficacy in the treatment of obstructive sleep apnea (OSA) as compared with in-laboratory titration.
19. In many research articles, it is commonly reported that long-term compliance for sleep apnea patients nationally averages 50% to 60%. Despite this advancement, there remains a segment of the patient population that historically does not tolerate CPAP therapy well.
20. The degree to which patients’ complaints are reversed by a therapeutic intervention has no predictive value regarding patient satisfaction and treatment compliance.