在阻塞性睡眠呼吸暂停中CPAP治疗前和后综合性患者报告结果的评估
Adriana Loredana Pintilie1, Andreea Zabara Antal1,2, Ruxandra Stirbu1
1Clinical Hospital of Pulmonary Diseases Iași, 700116 Iasi, Romania.
Biomedicines
|November 27, 2025
概括
持续的正气道压力 (CPAP) 治疗显著改善了阻塞性睡眠呼吸暂停 (OSA) 症状,如嗜睡和情绪. 高CPAP坚持,而不是残留呼吸事件,预测了六个月的更好的患者报告结果和认知功能.
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统医学 呼吸系统医学
- 神经科学是一个神经科学.
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 对白天的警觉,情绪,认知和生活质量 (QoL) 有负面影响.
- 需要进一步了解CPAP治疗对患者报告结果 (PRO) 和认知功能的初始影响及其与坚持和残留呼吸事件的关系.
研究的目的:
- 在CPAP治疗六个月后,评估成年OSA患者的PRO和认知表现的变化.
- 确定PRO和认知功能的改善与CPAP坚持和残留呼吸事件 (例如,呼吸暂停-呼吸暂停指数 (AHI)) 之间的关联.
主要方法:
- 这是一项追溯观察性研究,从2024年1月到2025年5月,涉及72名成年OSA患者.
- 标准化评估包括爱普沃思睡眠度量 (ESS),WHOQOL-BREF,MoCA,DASS-21,GAD-7和PHQ-9在基线和CPAP启动后六个月进行.
- 主要终点:PROs和认知表现的变化. 二级终点:改善,CPAP坚持和剩余AHI之间的关联.
主要成果:
- 六个月后,ESS (14至8.6),PHQ-9 (7至7.1),GAD-7 (5至6.2) 和MoCA (24至25.3) 的显著改善.
- 在所有领域的WHOQOL-BREF得分都有所改善. 然而,剩余的过度白天嗜睡 (EDS) 和认知障碍在显著比例的患者中仍然存在.
- 高CPAP坚持 (平均87.7%,中位数95%) 预测ESS减少更大 (p=0.027) 和朝着PHQ-9改善的趋势 (p=0.066). 其余呼吸指数与PRO或认知分数没有相关性.
结论:
- 六个月的CPAP治疗显著改善了OSA患者的嗜睡,情绪,焦虑,认知和生活质量.
- 尽管有治疗,残留EDS和认知挑战仍然是常见的问题.
- 坚持CPAP是比剩余呼吸事件水平 (AHI,ODI) 更强的积极结果预测器.
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