Unité de Sommeil, Service de Pneumologie, Hôpital Saint-Antoine, Paris, France.
Sleep Med. 2010 Sep;11(8):777-84. doi: 10.1016/j.sleep.2010.04.008. Epub 2010 Jul 6.
Obstructive Sleep Apnoea Syndrome (OSAS) and insomnia are common pathologies sharing a high comorbidity. CPAP is a cumbersome treatment. Yet, CPAP compliance must remain optimal in order to reverse excessive daytime sleepiness and prevent the cardiovascular consequences of OSAS. But chronic insomnia could negatively affect CPAP compliance.
To assess the consequences of insomnia symptoms on long-term CPAP use.
A prospective study was conducted on 148 OSAS patients (RDI=39.0+/-21.3/h), age=54.8+/-11.8years, BMI=29.1+/-6.3kg/m(2), Epworth Score=12.2+/-5.4, on CPAP. Using the Insomnia Severity Index (ISI) as an indicator of insomnia (ISI14=moderate to severe insomnia) and baseline data (anthropometric data, sleeping medication intakes, CPAP compliance, Epworth, Pittsburgh Sleep Quality and ISI scores, polygraphic recording data), Data Mining analysis identified the major rules explaining the features "High" or "Low ISI" and "High" or "Low Use" in the groups defined, according to the median values of the ISI and the 6th month-compliance, respectively.
Median ISI was 15 and median 6th month-compliance was 4.38h/night. Moderate to severe insomnia complaint was found in 50% of patients. In the "High" and "Low ISI," the 6th month-compliance was not significantly different (3.7+/-2.3 vs 4.2+/-2.3h/night). In the classification models of compliance, the ISI was not a predictor of CPAP rejection or of long-term use, the predictor for explaining CPAP abandonment being the RDI, and the predictor of the 6th month-compliance being the one month-compliance.
Insomnia symptoms were highly prevalent in OSAS patients, but had no impact on CPAP rejection or on long-term compliance.
阻塞性睡眠呼吸暂停综合征（OSAS）和失眠是常见的共病，具有高度的共病性。CPAP 是一种繁琐的治疗方法。然而，为了逆转日间过度嗜睡并预防 OSAS 的心血管后果，CPAP 的依从性必须保持最佳。但是慢性失眠可能会对 CPAP 的依从性产生负面影响。
评估失眠症状对长期 CPAP 使用的影响。
对 148 例 OSAS 患者（RDI=39.0+/-21.3/h）进行前瞻性研究，年龄=54.8+/-11.8 岁，BMI=29.1+/-6.3kg/m(2)，Epworth 评分为 12.2+/-5.4，使用 CPAP。使用失眠严重程度指数（ISI）作为失眠的指标（ISI14=中度至重度失眠）和基线数据（人体测量数据、睡眠药物摄入、CPAP 依从性、Epworth、匹兹堡睡眠质量和 ISI 评分、多导睡眠图记录数据），数据挖掘分析确定了主要规则，这些规则解释了根据 ISI 和第 6 个月依从性的中位数定义的组中“高”或“低 ISI”和“高”或“低使用”的特征。
中位 ISI 为 15，中位第 6 个月依从性为 4.38h/夜。50%的患者有中度至重度失眠症状。在“高”和“低 ISI”中，第 6 个月的依从性没有显著差异（3.7+/-2.3 与 4.2+/-2.3h/夜）。在 CPAP 拒绝或长期使用的分类模型中，ISI 不是 CPAP 放弃的预测因子，预测 CPAP 放弃的是 RDI，预测第 6 个月依从性的是第 1 个月的依从性。
OSAS 患者中失眠症状非常普遍，但对 CPAP 拒绝或长期依从性没有影响。
