在轻度阻塞性睡眠呼吸暂停时长期坚持持续的正气道压力
Min Qiao1, Yiyu Xie2, Armand Wolff3
1Pulmonary and critical care medicine, University of Rochester Medical Center, 601 Elmwood Ave, 14642, Rochester, NY, USA. min_qiao@urmc.rochester.edu.
BMC pulmonary medicine
|September 1, 2023
概括
对于轻度阻塞性睡眠呼吸暂停 (OSA) 的持续正气道压力 (CPAP) 治疗的长期坚持是低的,仅影响25.7%的患者. 在前三个月的早期坚持可以预测轻度OSA患者的长期成功.
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统医学 呼吸系统医学
- 公共卫生 公共卫生
背景情况:
- 持续正气道压力 (CPAP) 治疗是阻塞性睡眠呼吸暂停 (OSA) 的标准治疗方法.
- 显著的百分比的OSA患者表现出不良的耐受性和低长期坚持CPAP治疗.
- 患有轻度OSA的患者可能面临较高的不坚持的风险,因为症状严重程度和健康风险较低.
研究的目的:
- 通过家庭睡眠呼吸暂停测试 (HSAT) 来调查首次使用者被诊断患有轻度OSA的长期CPAP坚持的患病率.
- 在这个患者群体中确定与长期CPAP坚持相关的因素.
主要方法:
- 通过HSAT对222名首次使用CPAP的患者进行了回顾性分析,诊断出轻度OSA (5 <= 呼吸暂停-呼吸暂停指数 <15).
- 合规性定义为CPAP使用>= 4小时/晚上>= 70%的夜晚连续30天.
- 在第12个月评估的长期坚持;合规和不合规组之间的因素比较 (P <0.1).
主要成果:
- 只有25.7% (57分之222) 的患者在12个月后表现出长期CPAP的坚持.
- 与更高的坚持相关的因素包括年龄较大,BMI较低,床上伴侣的存在,非吸烟者身份和特定的并发症 (DM,CHF).
- 缺乏抑郁症和早期CPAP遵守 (第1,3,6,9个月) 也与持续的坚持有关.
结论:
- 在患有轻度OSA的患者中,长期CPAP的坚持仍然很低.
- 在前三个月内早期遵守CPAP是轻度OSA患者长期成功的重要预测指标.
- 识别预测因素可以帮助量身定制干预措施以提高坚持率.
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