Jokic R, Klimaszewski A, Crossley M, Sridhar G, Fitzpatrick M F
Division of Respiratory Medicine, University of Saskatchewan, Saskatoon, Canada.
Chest. 1999 Mar;115(3):771-81. doi: 10.1378/chest.115.3.771.
The aim of this study was to compare the relative efficacy of continuous positive airway pressure (CPAP) and positional treatment in the management of positional obstructive sleep apnea (OSA), using objective outcome measures.
A prospective, randomized, single blind crossover comparison of CPAP and positional treatment for 2 weeks each.
A university teaching hospital.
Thirteen patients with positional OSA, aged (mean+/-SD) 51+/-9 years, with an apnea-hypopnea index (AHI) of 17+/-8.
(1) Daily Epworth Sleepiness Scale scores; (2) overnight polysomnography, an objective assessment of sleep quality and AHI; (3) maintenance of wakefulness testing; (4) psychometric test battery; (5) mood scales; (6) quality-of-life questionnaires; and (7) individual patient's treatment preference.
Positional treatment was highly effective in reducing time spent supine (median, 0; range, 0 to 32 min). The AHI was lower (mean difference, 6.1; 95% confidence interval [CI], 2 to 10.2; p = 0.007), and the minimum oxygen saturation was higher (4%; 95% CI, 1% to 8%; p = 0.02) on CPAP as compared with positional treatment. There was no significant difference, however, in sleep architecture, Epworth Sleepiness Scale scores, maintenance of wakefulness testing sleep latency, psychometric test performance, mood scales, or quality-of-life measures.
Positional treatment and CPAP have similar efficacy in the treatment of patients with positional OSA.
本研究旨在采用客观结局指标，比较持续气道正压通气（CPAP）和体位治疗在体位性阻塞性睡眠呼吸暂停（OSA）管理中的相对疗效。
一项前瞻性、随机、单盲交叉比较研究，CPAP和体位治疗各持续2周。
一家大学教学医院。
13例体位性OSA患者，年龄（均值±标准差）为51±9岁，呼吸暂停低通气指数（AHI）为17±8。
（1）每日爱泼沃斯思睡量表评分；（2）整夜多导睡眠图，对睡眠质量和AHI的客观评估；（3）清醒维持测试；（4）心理测试组；（5）情绪量表；（6）生活质量问卷；（7）患者个人的治疗偏好。
体位治疗在减少仰卧位时间方面非常有效（中位数为0；范围为0至32分钟）。与体位治疗相比，CPAP治疗时AHI更低（平均差值为6.1；95%置信区间[CI]为2至10.2；p = 0.007），最低血氧饱和度更高（4%；95%CI为1%至8%；p = 0.02）。然而，在睡眠结构、爱泼沃斯思睡量表评分、清醒维持测试的睡眠潜伏期, 心理测试表现、情绪量表或生活质量测量方面，两者没有显著差异。
体位治疗和CPAP在治疗体位性OSA患者方面具有相似的疗效。
