Implementation and feasibility of an interdisciplinary pediatric positive airway pressure adaptation program in a Brazilian public sleep clinic

Introduction: The early diagnosis and treatment of pediatric obstructive sleep apnea (OSA) can improve academic performance of affected children, in addition to enhancing their cognitive and social development. Since the effective use of positive airway pressure (PAP) is limited by difficulties in adherence to the device, adaptation and engagement programs may improve outcomes in pediatric patients. Objective: The aim of this study is to describe an interdisciplinary program to improve PAP adherence among children with OSA in Brazil's public health system, also assessing its feasibility, acceptability, fidelity, and scalability based on implementation science frameworks, with the goal of informing sustainable clinical practice and public policy. Method: The program is based on the CPAP Program developed and implemented by the Children's Hospital of the Philadelphia Sleep Center. This prospective study will involve patients aged 1 year to 18 years treated at the children's sleep clinic who have a diagnosis of OSA and indication for PAP treatment. The main outcome measures will include (1) percentage of patients who return for a follow-up visit within 4 months of treatment initiation, (2) the median number of days from the initial visit to the first follow-up visit, (3) task analysis questionnaire, (4) objective data obtained from the device's memory card. Conclusion: The program proposed is expected to provide an integrated clinical service, optimizing the time of adaptation to PAP, increasing adherence rates, and reducing the costs associated with medical problems of untreated OSA.