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Vol. 43. Issue 1.
Pages 16-21 (January 2007)
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Vol. 43. Issue 1.
Pages 16-21 (January 2007)
Original Articles
DOI: 10.1016/S1579-2129(07)60015-9
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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
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Luis Torre Bouscoulet
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
, Elodia López Escárcega, Armando Castorena Maldonado, Juan Carlos Vázquez García, María Sonia Meza Vargas, Rogelio Pérez-Padilla
Clínica de Trastornos Respiratorios del Dormir, Instituto Nacional de Enfermedades Respiratorias, Secretaría de Salud, México DF, Mexico
Article information
Objective

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.

Patients and methods

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.

Results

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.

Conclusions

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.

Key words:
Obstructive sleep apnea syndrome (OSAS)
Apnea
Therapeutics
Sleep
Continuous positive airway pressure (CPAP)
Compliance
Objetivo

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.

Pacientes y métodos

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.

Resultados

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.

Conclusiones

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.

Palabras clave:
SAOS
Apnea
Tratamiento
Sueño
CPAP
Cumplimiento
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Copyright © 2007. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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