Division of Pulmonary, Critical Care and Sleep Medicine, University of Tennessee Health Science Center College of Medicine, Memphis, TN 38163, USA.
Am J Med Sci. 2013 Aug;346(2):104-7. doi: 10.1097/MAJ.0b013e31826d6421.
Obstructive sleep apnea (OSA) is a highly prevalent disorder associated with significant morbidity and multiple complications. A large proportion of patients with OSA also have a coexisting primary psychiatric disorder. The effect of psychiatric disorders on the ability to tolerate continuous positive airway pressure (CPAP) titration is not known. In this study, whether the presence of psychiatric disorders precludes the patients' ability to tolerate CPAP titration for OSA was investigated. A retrospective chart review on a sample of 284 patients who underwent sleep studies in a single-center, university-based Veterans Affairs hospital was performed. A total of 143 patients with OSA who underwent titration of CPAP therapy were identified. The prevalence of psychiatric disorders between patients who tolerated titration and those who did not tolerate it was compared using the χ² test. The percentages of patients with psychiatric disorders who tolerated and did not tolerate CPAP were 33.6% and 33.3%, respectively. No statistically significant difference between the 2 groups (χ² = 0.051 with 1 degree of freedom; P = 0.82) was found. The predominantly male patient population, exclusion of mild OSA, lack of data about the level of control of the psychiatric symptoms and the sleep technicians not being blinded to the patients' psychiatric diagnoses were some of the limitations of this study. No significant difference existed in the prevalence of psychiatric disorders between patients intolerant to CPAP titration and those who tolerated CPAP for OSA.
阻塞性睡眠呼吸暂停（OSA）是一种高发疾病，与多种发病率和并发症密切相关。相当一部分 OSA 患者还合并有原发性精神疾病。精神疾病对持续气道正压通气（CPAP）滴定耐受性的影响尚不清楚。本研究旨在探究精神疾病是否会影响 OSA 患者对 CPAP 滴定的耐受性。对在单一中心、大学附属退伍军人事务医院进行睡眠研究的 284 例患者的病历进行了回顾性图表分析。共确定了 143 例接受 CPAP 治疗滴定的 OSA 患者。采用卡方检验比较了能够耐受和不能耐受 CPAP 滴定的患者之间精神疾病的患病率。有精神疾病的患者中分别有 33.6%和 33.3%能够耐受和不能耐受 CPAP，两组之间无统计学差异（卡方=0.051，自由度为 1；P=0.82）。本研究存在一些局限性，例如患者主要为男性、排除了轻度 OSA、缺乏对精神症状控制程度的数据以及睡眠技师对患者的精神诊断并不知情。对 CPAP 滴定不耐受的患者和能够耐受 CPAP 治疗 OSA 的患者之间，精神疾病的患病率无显著差异。
