Department of Respiratory Medicine, Tianjin Medical University General Hospital, Tianjin, China.
Respir Care. 2012 Feb;57(2):238-43. doi: 10.4187/respcare.01136. Epub 2011 Jul 12.
CPAP is the first choice for most patients with obstructive sleep apnea (OSA), but the adherence to CPAP is suboptimal. The purpose of this study was to assess the adherence to CPAP therapy of Chinese OSA patients with CPAP therapy.
Two-hundred ten patients who had been diagnosed with OSA and had experienced CPAP titration trial as prescribed were enrolled in this study. Subjects were identified by reviewing our Snoring and Sleep Apnea Unit's records. The patients were interviewed by telephone and were asked to assess their CPAP use time. Those who said their CPAP use time was less than 4 h/d for 70% of the nights per week were questioned about their reasons for non-adherence.
Seventeen patients were lost to follow-up. One-hundred ninety-three patients participated in our survey. Patient demographics included male/female (162/31), mean ± SD age (51.91 ± 10.10 y), and mean apnea-hypopnea index (59.99 ± 21.51 events/h). At the time of the interview (59 ± 32 months after initial titration trial), 100 of 193 patients (51.8%) were still using CPAP, 29 of 193 patients (15.0%) had abandoned CPAP after using it for a period, and 64 of 193 patients (33.2%) had never commenced therapy after titration. The most common reasons cited by the patients for the poor adherence were they were not able to acclimatize to the CPAP during the titration night, they did not perceive the need or the benefits of the treatment, or found it troublesome to use CPAP every night.
The CPAP adherence is low in Tianjin, China. Only one half of these patients remained adherent to the treatment, and the other one half of these patients either never initiated the treatment or had abandoned CPAP use. To improve CPAP adherence, the medical staff should pay attention to making the titration trial a comfortable first CPAP experience for the patients. It is also very important to give the patients education and support about CPAP use in the follow-up, especially early on in this treatment.
CPAP 是大多数阻塞性睡眠呼吸暂停（OSA）患者的首选治疗方法，但 CPAP 的依从性并不理想。本研究的目的是评估接受 CPAP 治疗的中国 OSA 患者对 CPAP 治疗的依从性。
本研究纳入了 210 例经诊断为 OSA 并按规定接受 CPAP 滴定试验的患者。通过回顾我们的打鼾和睡眠呼吸暂停科的记录来确定患者。通过电话对患者进行访谈，并要求他们评估自己的 CPAP 使用时间。对于那些每周有 70%的夜晚 CPAP 使用时间少于 4 小时的患者，我们会询问他们不依从的原因。
17 例患者失访。193 例患者参与了我们的调查。患者的人口统计学特征包括男/女（162/31）、平均年龄（51.91 ± 10.10 岁）和平均呼吸暂停低通气指数（59.99 ± 21.51 次/小时）。在访谈时（初始滴定试验后 59 ± 32 个月），193 例患者中有 100 例（51.8%）仍在使用 CPAP，193 例患者中有 29 例（15.0%）在使用一段时间后放弃了 CPAP，193 例患者中有 64 例（33.2%）在滴定后从未开始治疗。患者不依从的最常见原因是在滴定夜期间无法适应 CPAP、他们认为没有必要或没有从治疗中受益，或者觉得每晚使用 CPAP 很麻烦。
在中国天津，CPAP 的依从性较低。只有一半的患者仍然坚持治疗，另一半患者要么从未开始治疗，要么放弃了 CPAP 治疗。为了提高 CPAP 的依从性，医务人员应该注意使滴定试验成为患者第一次使用 CPAP 的舒适体验。在随访中，特别是在治疗早期，给予患者关于 CPAP 使用的教育和支持也非常重要。
