University of Pennsylvania School of Nursing, Biobehavioral Health Sciences Division, USA.
Sleep Med Rev. 2011 Dec;15(6):343-56. doi: 10.1016/j.smrv.2011.01.003. Epub 2011 Jun 8.
Continuous positive airway pressure (CPAP) is a highly efficacious treatment for obstructive sleep apnea (OSA) but adherence to the treatment limits its overall effectiveness across all age groups of patients. Factors that influence adherence to CPAP include disease and patient characteristics, treatment titration procedures, technological device factors and side effects, and psychological and social factors. These influential factors have guided the development of interventions to promote CPAP adherence. Various intervention strategies have been described and include educational, technological, psychosocial, pharmacological, and multi-dimensional approaches. Though evidence to date has led to innovative strategies that address adherence in CPAP-treated children, adults, and older adults, significant opportunities exist to develop and test interventions that are clinically applicable, specific to sub-groups of patients likely to demonstrate poor adherence, and address the multi-factorial nature of CPAP adherence. The translation of CPAP adherence promotion interventions to clinical practice is imperative to improve health and functional outcomes in all persons with CPAP-treated OSA.
持续气道正压通气(CPAP)是治疗阻塞性睡眠呼吸暂停(OSA)的一种非常有效的方法,但由于患者对治疗的依从性限制了其在所有年龄段患者中的总体效果。影响 CPAP 依从性的因素包括疾病和患者特征、治疗滴定程序、技术设备因素和副作用以及心理和社会因素。这些影响因素指导了促进 CPAP 依从性的干预措施的发展。已经描述了各种干预策略,包括教育、技术、心理社会、药理学和多维方法。尽管迄今为止的证据提出了一些创新性策略,以解决 CPAP 治疗的儿童、成人和老年人的依从性问题,但仍有很大机会开发和测试针对可能表现出较差依从性的特定亚组患者以及解决 CPAP 依从性的多因素性质的干预措施。将 CPAP 依从性促进干预措施转化为临床实践对于改善所有 CPAP 治疗 OSA 患者的健康和功能结果至关重要。