CPAP Compliance in Patients with Obstructive Sleep Apnea Syndrome - Article Example

Running head: ARTICLE ANALYSIS Article Analysis Affiliation. Article Analysis In the article, "CPAP compliance in patients with obstructive sleep apnea syndrome," Ozkan Yetkin, Erdogan Kunter, and Hakan Gunen discuss CPAP treatment and how it affects individuals with sleep apnea syndrome. The authors open the article with a very clear problem statement, stating that they wished to "evaluate the factors affecting adherence to the CPAP treatment" (Yetkin, Kunter & Gunen, 2008, p. 365). There is certainly a need for this type of analysis because, as the authors assess and as the scientific community is already aware, CPAP is often the initial form of treatment presented to patients with OSAS, and this treatment is not an easy of pleasant experience for most individuals suffering from sleep apnea. For instance, most individuals that undergo treatment have trouble with the machine and masks used during treatment, thus many individuals with sleep apnea often want to avoid the treatment, although the first few weeks of the treatment are usually vital. Therefore, this issue is something that must be studied with further analysis. Thus, the researchers state their hypothesis as such: "In this study, we aimed to evaluate, prospectively, the factors affecting adherence to the CPAP treatment and the correlations of apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), oxygen desaturation index (OD), arousal index (RI), the lowest oxygen saturation (LO), and the body mass index (BMI) with each other, in patients with OSAS" (Yetkin, Kunter & Gunen, 2008, p. 365). The researchers then proceed with a very clear presentation of their study, discussing the methods in some detail. The article does a fantastic job of defining the size of the sample, discussing inclusion criteria, sample inclusion criteria, comparability, confounding variables, and also mentions how the subjects were assignment to groups. The authors clearly state: "Seventy-one patients were enrolled to this study. Patients were divided into three groups according to CPAP usage. Group I consisted of patients who had never used CPAP, group II consisted of patients who had used CPAP occasionally, and group-III patients had used CPAP treatment regularly. Group-III patients had higher apnea- hypopnea index (AHI) than groups I and II (respectively, Oxygen desaturation index was significantly higher in group-III patients comparing to groups I and II" (Yetkin, Kunter & Gunen, 2008, p. 366). There is also more information provided by the researchers. They state: "After 3 months, the patients were asked about how good they had adhered to the CPAP treatment. Then, the patients were divided into three groups according to CPAP usage ratio. Group I consisted of patients who had never used CPAP (n=23), group II consisted of patients who had used CPAP occasionally (n=24), and group-III patients had used CPAP treatment regularly (n=24). By definition, patients who did not use CPAP each and every day of the 3 months period without a valid or acceptable reason (overnight travel, CPAP device dysfunction, etc.) were classified into the group II." (Yetkin, Kunter & Gunen, 2008, p. 366). While this information is presented clearly, there are some issues that are not mentioned in the study. There is no mention of convenience and randomization of the sample, but considering the circumstances of the study, this was probably not necessary. Demographics are also not discussed, but may also not have contributed much to the study since the focus is on a particular disease. Variables are not very clearly defined, however, and this would have added to the clarity of the study. There is also no mention of potential sources of sample bias, or strengths and weaknesses of sample characteristics. This is another flaw in this study that could have contributed, and provided more information about the disease itself. As for assessment design and characteristics, the study does state the outcome to be studied-basically the adherence to CPAP treatment. The length of the study is mentioned in the article (a course of three months), and instruments are also discussed (the machine used for this type of treatment). Variables and validity are not clearly discussed in the article, however. The research and data analysis are clearly discussed. The authors do measure the strengths of the study results, account for the subjects, discuss confounding variables and control, statistical testing, and. threats to the validity. The researchers state: "Full-night polysomnography was performed using conventional instrumentation and analysis according to the recommendations on syndrome definition and measurement techniques published by the American Academy of Sleep Medicine. Sleep stages were detailed by standard electroencephalographic, electro-oculographic, and electromyographic (EMG) criteria. Apneas and hypopneas were recorded by oronasal flow cannulae attached to a pneumotachograph. Arterial oxygen saturation was measured by pulse oximetry using a finger probe. Thoracic and abdominal movements were recorded by using inductive plethysmography to document respiratory effort. Periodical limb movements were recorded from surface EMG electrode on tibialis anterior muscle of the lower extremity. Obstructive apneas were defined as absence of airflow for longer than m10 s; obstructive hypopneas as a 50% decrease in airflow or a clear but lesser decrease in airflow if coupled with either a desaturation of >3% or an arousal in the context of ongoing respiratory effort. All records were scored" (Yetkin, Kunter & Gunen, 2008, p. 366). Thus, they provide a very clear emphasis on research and data. Their statistics are also very clear: "Mean age of patients (M/F=40/31) was 51.511.4 (range 30-75; Table 1). AHI, OD, RI, ESS, LO, and BMI were compared between groups. There was no significant difference between groups I and II (p>0.05) in terms of ESS. ESS of group III was significantly higher than groups I and II (p=0.007 and p=0.002, respectively). Group-I patients had lower AHI than group-II patients (p=0.049). Group-III patients had significantly higher AHI than groups I and II (p Read More