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Effects of CPAP Treatment Interruption Due to Disasters: Patients with Sleep-disordered Breathing in the Great East Japan Earthquake and Tsunami Area

Published online by Cambridge University Press:  04 December 2013

Fumitaka Mito ,
Tsuguo Nishijima ,
Shigeru Sakurai ,
Tetsuya Kizawa ,
Keisuke Hosokawa ,
Susumu Takahashi ,
Akira Suwabe ,
Hiroshi Akasaka  and
Sei-ichiro Kobayashi
Fumitaka Mito
Affiliation:
Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Tsuguo Nishijima*
Affiliation:
Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Shigeru Sakurai
Affiliation:
Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Tetsuya Kizawa
Affiliation:
Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Keisuke Hosokawa
Affiliation:
Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Susumu Takahashi
Affiliation:
Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Akira Suwabe
Affiliation:
Department of Laboratory Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Hiroshi Akasaka
Affiliation:
Department of Disaster Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Sei-ichiro Kobayashi
Affiliation:
Department of Disaster Medicine, Iwate Medical University School of Medicine, Iwate, Japan
*
Correspondence: Tsuguo Nishijima, MD, PhD Division of Behavioral Sleep Medicine Iwate Medical University School of Medicine 19-1 Uchimaru Morioka City, Iwate Prefecture, Japan E-mail tsuguo@ck9.so-net.ne.jp
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Abstract

Introduction

The 2011 Great East Japan Earthquake caused major disruptions in the provision of health care, including that for patients with sleep-disordered breathing (SDB) using a nasal continuous positive airway pressure (nCPAP) device. This study investigated the ability of SDB patients to continue using the nCPAP device in the weeks immediately following the earthquake, whether inability to use the nCPAP device led to symptom relapse, and measures that should be taken to prevent disruptions in nCPAP therapy during future disasters.

Hypothesis

If nCPAP devices cannot be used during disasters, SDB patients’ health will be affected negatively.

Methods

Within 14 days of the disaster, 1,047 SDB patients completed a questionnaire that collected data regarding ability to use, duration of inability to use, and reasons for inability to use the nCPAP device; symptom relapse while unable to use the nCPAP device; ability to use the nCPAP device use at evacuation sites; and recommendations for improvement of the nCPAP device.

Results

Of the 1,047 patients, 966 (92.3%) had been unable to use the nCPAP device in the days immediately following the earthquake. The most common reason for inability to use the nCPAP device was power failure, followed by anxiety about sleeping at night due to fear of aftershocks, involvement in disaster-relief activities, loss of the nasal CPAP device, and fear of being unable to wake up in case of an emergency. Among the 966 patients, 242 (25.1%) had experienced relapse of symptoms, the most common of which was excessive daytime sleepiness (EDS), followed by insomnia, headache, irritability, and chest pain.

Conclusion

Developing strategies for the continuation of nCPAP therapy during disasters is important for providing healthy sleeping environments for SDB patients in emergency situations.

MitoF, NishijimaT, SakuraiS, KizawaT, HosokawaK, TakahashiS, SuwabeA, AkasakaH, KobayashiS. Effects of CPAP Treatment Interruption Due to Disasters: Patients with Sleep-disordered Breathing in the Great East Japan Earthquake and Tsunami Area. Prehosp Disaster Med. 2013;28(6):547-555.

Keywords

continuous positive airway pressuredisastersheltersleepiness
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 28 , Issue 6 , December 2013 , pp. 547 - 555
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2013 

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