title: Effects of CPAP treatment interruption due to disasters: patients with sleep-disordered breathing in the Great East Japan Earthquake and tsunami area.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  Developing strategies for the continuation of nCPAP therapy during disasters is important for providing healthy sleeping environments for SDB patients in emergency situations.
authors.affiliation: 1 Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Mito
authors.forename: Tsuguo
authors.initials: T
authors.lastname: Nishijima
authors.forename: Shigeru
authors.initials: S
authors.lastname: Sakurai
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kizawa
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hosokawa
authors.forename: Susumu
authors.initials: S
authors.lastname: Takahashi
authors.forename: Akira
authors.initials: A
authors.lastname: Suwabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Akasaka
authors.forename: Sei-ichiro
authors.initials: S
authors.lastname: Kobayashi
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000706:statistics & numerical data; D004190:Disasters; D055866:Earthquakes; D004560:Electricity; D006801:Humans; D007564:Japan; D011788:Quality of Life; D012891:Sleep Apnea Syndromes / Q000628:therapy; D011795:Surveys and Questionnaires; D057192:Tsunamis