ArticleSleep & breathing = Schlaf & Atmung2026
A novel age-based physiological definition of adherence to pediatric long-term non-invasive ventilation: an exploratory study.
Article in Sleep & breathing = Schlaf & Atmung, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe indications for pediatric long-term non-invasive ventilation (LT-NIV) have expanded. However, a standardized definition of pediatric adherence is lacking.
objectivesTo propose a novel physiological definition of adherence to pediatric LT-NIV and compare it with the two commonly used adult-derived definitions.
methodsRetrospective cross-sectional study including all eligible children aged 0.15-18 years enrolled in the LT-NIV follow-up program at Hospital Garrahan, Argentina. Clinical data were obtained from medical records and adherence from device memory downloads. The proposed definition classified patients as "adherent" when LT-NIV use reached ≥ 70% of the minimum age-specific recommended sleep duration (American Academy of Sleep Medicine consensus) on ≥ 70% of nights, replacing a fixed threshold with one tailored to each child´s sleep needs. This was compared to the current(≥ 4 h/night on ≥ 70% of nights) and classic (≥ 4 h/night on ≥ 50% of nights) adult-derived definitions.
resultsEighty patients were included (median age 9.01years, IQR 5.96-14.09). The most frequent diagnoses were neuromuscular (31%) and genetic disorders (15%). LT-NIV was initiated electively in 91%, 75% reported sleep-disordered breathing symptoms, polysomnography was abnormal in 95.2%. Adherence rates were 66.25% (novel definition); 83.75% (classic definition) and 78.75% (current definition), p = 0.0005 and p = 0.0039 respectively. Poorer adherence was associated with younger age, developmental delay, absence of symptoms, earlier ventilation initiation and lower pressure settings.
conclusionsOur results highlight an overestimation of adherence when adult definitions are used. This first study explores a novel pediatric adherence definition for LT-NIV. Our research calls for action to discuss new international pediatric adherence thresholds.
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