UW Medicine Sleep Center, Division of Pulmonary Critical Care, University of Washington, Seattle, WA 98104, USA.
Sleep. 2013 Feb 1;36(2):221-7. doi: 10.5665/sleep.2376.
Black race has been associated with decreased continuous positive airway pressure (CPAP) adherence. Short sleep duration, long sleep latency, and insomnia complaints may affect CPAP adherence as they affect sleep and opportunity to use CPAP. We assessed whether self-reported sleep measures were associated with CPAP adherence and if racial variations in these sleep characteristics may explain racial differences in CPAP adherence.
Analysis of data from a randomized controlled trial (HomePAP), which investigated home versus laboratory-based diagnosis and treatment of obstructive sleep apnea.
Seven American Academy of Sleep Medicine-accredited sleep centers in five cities in the United States.
Enrolled subjects (n = 191) with apnea-hypopnea index ≥ 15 and sleepiness (Epworth Sleepiness Scale > 12).
N/A.
Multivariable regression was used to assess if subjective sleep measures and symptoms predicted 3-mo CPAP use. Mediation analysis was used to assess if sleep measures mediated the association of race with CPAP adherence. Black participants reported shorter sleep duration and longer sleep latency at baseline than white and Hispanic participants. Shorter sleep duration and longer sleep latency predicted worse CPAP adherence. Sleep duration mediated the association of black race with lower CPAP adherence. However, insomnia symptoms were not associated with race or CPAP adherence.
Among subjects with similar severity of obstructive sleep apnea and sleepiness, baseline self-reported sleep duration and latency, but not perceived insomnia, predicted CPAP adherence over 3 mo. Sleep duration explains some of the observed differences in CPAP use by race. Sleep duration and latency should be considered when evaluating poor CPAP adherence.
PORTABLE MONITORING FOR DIAGNOSIS AND MANAGEMENT OF SLEEP APNEA (HOMEPAP) URL: http://clinicaltrials.gov/show/NCT00642486. NIH clinical trials registry number: NCT00642486.
黑种人被认为与持续气道正压通气（CPAP）治疗的依从性降低有关。睡眠时间短、入睡潜伏期长和失眠投诉可能会影响 CPAP 治疗的依从性，因为它们会影响睡眠和使用 CPAP 的机会。我们评估了自我报告的睡眠测量指标是否与 CPAP 治疗的依从性相关，以及这些睡眠特征的种族差异是否可以解释 CPAP 治疗的依从性的种族差异。
对一项随机对照试验（HomePAP）的数据进行分析，该试验调查了家庭与实验室为基础的诊断和治疗阻塞性睡眠呼吸暂停。
美国五个城市的七个美国睡眠医学协会认可的睡眠中心。
纳入的受试者（n=191），呼吸暂停低通气指数（apnea-hypopnea index，AHI）≥15 且有嗜睡（Epworth 嗜睡量表评分>12）。
无。
多变量回归用于评估主观睡眠测量和症状是否预测 3 个月 CPAP 治疗的使用。中介分析用于评估睡眠测量是否介导了种族与 CPAP 治疗的依从性之间的关系。黑人参与者在基线时报告的睡眠时间较短，入睡潜伏期较长，而白人参与者和西班牙裔参与者则睡眠时间较短，入睡潜伏期较长，预示着 CPAP 治疗的依从性较差。睡眠时间介导了黑人种族与较低的 CPAP 治疗的依从性之间的关联。然而，失眠症状与种族或 CPAP 治疗的依从性无关。
在患有相似严重程度的阻塞性睡眠呼吸暂停和嗜睡的受试者中，基线时自我报告的睡眠时间和潜伏期，但不是感知到的失眠，预测了 3 个月的 CPAP 治疗的依从性。睡眠时间解释了观察到的 CPAP 治疗的依从性的种族差异的一部分。在评估 CPAP 治疗的依从性时，应考虑睡眠时间和潜伏期。
便携式监测诊断和管理睡眠呼吸暂停（HOMEPAP）URL：http://clinicaltrials.gov/show/NCT00642486。NIH 临床试验注册编号：NCT00642486。
