在欧洲睡眠呼吸暂停数据库中对轻度至中度睡眠暂停的治疗选择
Benedikt Fridriksson1,2, Jan Hedner1,2, Ding Zou2
1Sleep Disorders Centre, Respiratory Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
ERJ open research
|December 31, 2025
概括
部推进装置 (MAD) 在轻度至中度阻塞性睡眠呼吸暂停 (OSA) 中使用不足. 增加可访问性和退款大大预测了MAD建议,这表明在OSA治疗中可能会得到更广泛的采用.
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统医学 呼吸系统医学
- 医疗器械 医疗器械
背景情况:
- 阳性气道压力 (PAP) 和下推进装置 (MADs) 是指南推的治疗方法,用于轻度至中度阻塞性睡眠呼吸暂停 (OSA).
- 在临床实践中,在PAP和MAD之间进行选择的预测因素尚未完全理解.
- 跨治疗中心MAD推率的变化表明组织因素的潜在影响.
研究的目的:
- 确定影响MADs与PAP推的临床和组织因素,用于患有轻度至中度OSA的患者.
- 评估MAD可访问性和退款对治疗建议的影响.
- 评估目前使用的MAD与PAP相比,用于轻度至中度的OSA.
主要方法:
- 一项横截面研究分析了欧洲睡眠呼吸暂停数据库对新诊断的轻度至中度OSA患者的数据.
- 采用了回归模型,结合了患者的人口统计数据,爱普沃思睡眠度量得分,OSA严重程度,并发症指数和MAD可访问性/报销.
- 关于MAD网站可访问性和退款的数据是通过问卷收集的.
主要成果:
- 在10,109名患者中,65.5%接受了PAP,34.5%被推MAD,中心对中心的差异很大 (0%至76%).
- 有利于MAD推的因素包括较轻的OSA,较少的间歇性缺氧,没有白天嗜睡,较低的并发症得分和没有失眠诊断.
- 更高的MAD可访问性 (OR 2.3) 和报销 (OR 1.5) 是MAD治疗建议的重要预测因素.
结论:
- 对于轻度至中度的OSA,MADs的推较PAP少,特别是在疾病负担较大的患者中.
- MADs的可访问性和退款显著影响其推率.
- 医学药物可能是对轻度至中度OSA的未充分利用的治疗选择,通过改善获取和覆盖来增加使用的潜力.
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