1041 Poor Adherence and Suboptimal Response to PAP Therapy in Epilepsy
Bibliographic record
Abstract
Obstructive sleep apnea (OSA) is common in epilepsy patients, and treatment adherence issues are confronted daily. Positive airway pressure (PAP) adherence may be even more challenging for epilepsy patients than those who are healthy, but this has not been examined systematically. This study investigated whether epilepsy patients with comorbid OSA are more likely to be nonadherent to PAP therapy than adults with OSA but without epilepsy. This retrospective study included 23 epilepsy patients diagnosed with OSA and a group of 23 control subjects who did not have epilepsy but were matched for age, sex, and severity of OSA. All participants started PAP treatment, and subject’s adherence was continuously recorded electronically, including hours and days of use, pressure received, and any residual respiratory events. Comparisons were made at 1-month, 3-month, and 1-year following PAP initiation, and predictors to poor adherence were evaluated. Patients with epilepsy were less adherent to PAP than OSA control subjects during the 1-year follow-up period, with the most prominent difference in adherence rates seen at 1-month (13% versus 78%, p=0.007). During this first month interval, average PAP use was lower in epilepsy patients (4.7 ± 2.1 hours) relative to controls (6.1 ± 1.2 hours, p=0.01). Despite sustained PAP use, epilepsy patients had a greater residual apnea/hypopnea index (AHI) at all study endpoints and were five times more likely than controls to have residual apnea events above normal range (≥5 event/hour). However, no clinical characteristics could significantly predict poor PAP adherence in patients. Epilepsy patients are less likely to be adherent to PAP therapy, as compared to adults with OSA. Moreover, PAP therapy could not sufficiently reduce AHI in up to 72% of patients. These findings highlight the need for careful monitoring of PAP use in epilepsy patients, as untreated OSA may worsen seizure burden. Canadian Institutes of Health Research.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".