Estratégias personalizadas e mediadas por recursos tecnológicos para melhorar a adesão à terapia por pressão positiva em indivíduos com apneia obstrutiva do sono no contexto do Brasil: uma revisão narrativa

Abstract

Obstructive sleep apnea (OSA) is a chronic condition that impairs sleep quality and is associated with health risks. Positive airway pressure (PAP) is considered the first therapeutic option for moderate and severe cases of OSA. However, adherence to PAP is affected by several factors, such as intolerance to the interface, equipment noise, air leakage, and psychological factors, among others. In this context, the use of technological strategies shows itself as an alternative for situations of low compliance. Applications such as APPnea, MyPathway, and MiSAOS, besides websites and other online tools have been used for individuals with OSA and are described in the li terature. Some studies link, through these technological resources, questionnaires as a strategy to increase adherence, mainly as a form of evaluation and follow up of pressure therapy. Health education strategies with different approaches, such as interactive sessions with videos, active education platform, and hybrid education and interaction tools have also been delivered to the PAP users through these resources. Some technologies also allow the adoption of approaches supported by a library of motivational messages that deliver personalized feedback per PAP user profile, something made possible from artificial intelligence model mediated by machine l earning. In addition to s trategies mediated by apps or online platforms, other technologies are being used to enable detailed information on OSA patient engagement with PAP therapy such as telemonitoring of data via a cloud system or data transmission via USB. In the latter, the technology enables the sleep therapist and the patient to have greater contact and i nformation exchange during OSA treatment. It is emphasized that, as well as health education, the follow up of the individual with OSA should be mor e intense in the first m onth, and should be continuous, given the chronic nature of this health condition. Finally, the maintenance of long term clinical follow up in the context of OSA can be facilitated by technological resources capable of keeping the patient in treatment motivated to continue their treatment as well as to improve self management of this health condition.