Sleep Disorders Center, Section of Pulmonary and Critical Care, Department of Medicine, Chicago, IL, USA.
J Clin Sleep Med. 2013 Mar 15;9(3):199-205. doi: 10.5664/jcsm.2476.
CPAP adherence patterns are often established very early in the course of therapy. Our objective was to quantify patients' perception of CPAP therapy using a 6-item questionnaire administered in the morning following CPAP titration. We hypothesized that questionnaire responses would independently predict CPAP adherence during the first 30 days of therapy.
We retrospectively reviewed the CPAP perception questionnaires of 403 CPAP-naïve adults who underwent in-laboratory titration and who had daily CPAP adherence data available for the first 30 days of therapy. Responses to the CPAP perception questionnaire were analyzed for their association with mean CPAP adherence and with changes in daily CPAP adherence over 30 days.
Patients were aged 52 ± 14 years, 53% were women, 54% were African American, the mean body mass index (BMI) was 36.3 ± 9.1 kg/m(2), and most patients had moderate-severe OSA. Four of 6 items from the CPAP perception questionnaire- regarding difficulty tolerating CPAP, discomfort with CPAP pressure, likelihood of wearing CPAP, and perceived health benefit-were significantly correlated with mean 30-day CPAP adherence, and a composite score from these 4 questions was found to be internally consistent. Stepwise linear regression modeling demonstrated that 3 variables were significant and independent predictors of reduced mean CPAP adherence: worse score on the 4-item questionnaire, African American race, and non-sleep specialist ordering polysomnogram and CPAP therapy. Furthermore, a worse score on the 4-item CPAP perception questionnaire was consistently associated with decreased mean daily CPAP adherence over the first 30 days of therapy.
In this pilot study, responses to a 4-item CPAP perception questionnaire administered to patients immediately following CPAP titration independently predicted mean CPAP adherence during the first 30 days. Further prospective validation of this questionnaire in different patient populations is warranted.
CPAP 治疗顺应性模式通常在治疗过程的早期就已经建立。我们的目的是通过在 CPAP 滴定后次日早晨进行的 6 项问卷评估来量化患者对 CPAP 治疗的感知。我们假设问卷的回答会独立预测治疗的前 30 天 CPAP 治疗的依从性。
我们回顾性分析了 403 名 CPAP 初治成人的 CPAP 感知问卷，这些患者均接受了实验室滴定，并且在治疗的前 30 天有每日 CPAP 依从性数据。分析 CPAP 感知问卷的回答与平均 CPAP 依从性以及 30 天内每日 CPAP 依从性变化的相关性。
患者年龄为 52 ± 14 岁，53%为女性，54%为非裔美国人，平均 BMI（体重指数）为 36.3 ± 9.1 kg/m²，大多数患者患有中重度 OSA。CPAP 感知问卷的 6 项中的 4 项与平均 30 天 CPAP 依从性显著相关，包括难以耐受 CPAP、CPAP 压力不适、佩戴 CPAP 的可能性和感知健康获益，4 个问题的综合评分具有内部一致性。逐步线性回归模型显示，3 个变量是平均 CPAP 依从性降低的显著和独立预测因子：4 项问卷评分较差、非裔美国人种族和非睡眠专家进行多导睡眠图和 CPAP 治疗。此外，CPAP 感知问卷的评分越差，与治疗的前 30 天内平均每日 CPAP 依从性降低呈一致性相关。
在这项初步研究中，CPAP 滴定后立即对患者进行的 4 项 CPAP 感知问卷的回答独立预测了治疗的前 30 天 CPAP 依从性。需要在不同的患者群体中进一步前瞻性验证该问卷。
