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持续气道正压通气治疗阻塞性睡眠呼吸暂停的依从性:长期治疗后患者教育的影响。

Adherence to continuous positive airway pressure therapy for obstructive sleep apnea: impact of patient education after a longer treatment period.

机构信息

Medical Department 1, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.

出版信息

Respiration. 2010;80(1):32-7. doi: 10.1159/000243161. Epub 2009 Sep 26.

DOI:10.1159/000243161
PMID:19786730
Abstract

BACKGROUND

Continuous positive airway pressure (CPAP) is the standard treatment for obstructive sleep apnea (OSA) but it is often cumbersome so that adherence to CPAP therapy is limited.

OBJECTIVES

We evaluated adherence to CPAP therapy after an additional educative intervention in OSA patients after a longer treatment period.

METHODS

A short patient information program covering many aspects of symptoms, consequences and treatment of OSA was created, and standardized information sessions were developed to be given by an experienced sleep physician to >6,000 participants of patient support group meetings throughout Germany. They also received a booklet containing the essential information of the lectures. Of the 526 randomly selected members of these support groups receiving the anonymized questionnaire by mail, 475 CPAP patients sent the questionnaire back. Of these CPAP patients, 243 participated in a lecture und and had received a booklet (information group) and 232 CPAP patients had not attended a lecture (control group).

RESULTS

In the information group, a significantly higher daily usage of CPAP devices (6.9 +/- 0.9 h/day) was reported compared with the control group (5.7 +/- 1.3 h/day; p < 0.001). Furthermore, the score in the Epworth Sleepiness Scale (ESS) was found to be significantly lower in the information group (median ESS = 6, interquartile range, IQR, 4-8 vs. median = 11, IQR 8-13; p < 0.001).

CONCLUSIONS

Patients who attended our short information program showed a higher daily usage and a lower subjective daytime sleepiness. These results suggest that patients on CPAP therapy may benefit from education even after a longer treatment period.

摘要

背景

持续气道正压通气(CPAP)是治疗阻塞性睡眠呼吸暂停(OSA)的标准方法,但由于其使用较为繁琐,导致患者对 CPAP 治疗的依从性有限。

目的

我们评估了在 OSA 患者接受更长时间治疗后,通过额外的教育干预措施对 CPAP 治疗的依从性。

方法

我们创建了一个简短的患者信息计划,涵盖了 OSA 症状、后果和治疗的多个方面,并制定了标准化的信息课程,由一位经验丰富的睡眠医师在德国各地的患者支持小组会议上向超过 6000 名参与者讲授。他们还收到了一本包含讲座主要信息的小册子。在这些支持小组的 526 名随机选择的成员中,有 475 名 CPAP 患者通过邮件收到了匿名问卷,其中 243 名参加了讲座并收到了小册子(信息组),232 名 CPAP 患者未参加讲座(对照组)。

结果

信息组患者报告的 CPAP 设备每日使用时间(6.9+/-0.9 小时/天)明显高于对照组(5.7+/-1.3 小时/天;p<0.001)。此外,信息组的 Epworth 嗜睡量表(ESS)评分明显较低(中位数 ESS=6,四分位距 IQR,4-8 与中位数=11,IQR 8-13;p<0.001)。

结论

参加我们简短信息计划的患者每日使用 CPAP 设备的时间更长,主观白天嗜睡程度更低。这些结果表明,即使在治疗时间较长后,接受 CPAP 治疗的患者可能也会受益于教育。

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