Caregivers' outcome prioritization for home positive airway pressure in children: a mixed-methods study.

Study objectives: We sought to determine caregiver-reported priorities regarding the benefits, challenges, and further insights on home positive airway pressure (PAP) for children.

Methods: With this mixed-methods study we analyzed responses to an online survey by parents/caregivers of children (< 18 years of age) using home PAP for at least 3 months. A semistructured anonymous survey comprising multiple-choice and open-ended questions was used to assess caregivers' priorities for PAP outcomes and their perspectives on future research directions. Descriptive statistics were used to summarize caregiver and children demographics, as well as responses to multiple-choice questions. Thematic analysis was employed to synthesize the qualitative data from open-endend responses.

Results: Seventy-three caregivers completed the survey, 82% of whom were mothers. Over 90% rated improved sleep, rest, daytime energy levels, and breathing during sleep as very important or important benefits of PAP. A commonly reported challenge was children becoming dependent on PAP for sleep, which 76% of caregivers rated as a very important or important concern. For research priorities, improved breathing during sleep (77%) and reduced frequency of respiratory illness (73%) were the most commonly endorsed benefits. Key challenges identified as research priorities included mask-related issues (72%) and PAP dependency (57%). Four themes emerged from open-ended questions: (1) better nights and days, (2) adapting to home PAP, (3) finding the right mask, and (4) the importance of a team approach.

Conclusions: Caregivers identified both well-established respiratory benefits of PAP-such as improved breathing-and less frequently reported non-respiratory outcomes, including broader family well-being. Challenges such as mask-related issues and PAP dependency highlight areas where further research is needed.

Citation: Dannenberg VC, Ofosu D, Milne E, et al. Caregivers' outcome prioritization for home positive airway pressure in children: a mixed-methods study. J Clin Sleep Med. 2025;21(8):1407-1415.