Campbell Tessa, Pengo Martino F, Steier Joerg
1 Lane Fox Respiratory Unit/Sleep Disorders Centre, Guy's and St. Thomas' NHS Foundation Trust, London, UK ; 2 School of Medicine, Georgetown University, Washington DC, USA ; 3 Department of Medicine (DIMED), University of Padua, Italy ; 4 Faculty of Life Sciences and Medicine, King's College London, London, UK.
J Thorac Dis. 2015 May;7(5):938-42. doi: 10.3978/j.issn.2072-1439.2015.04.53.
Obstructive sleep apnoea (OSA) is the most common form of sleep-disordered breathing. The standard treatment, continuous positive airway pressure (CPAP), has limited long-term compliance. Alternative treatment options are required and new methods, including hypoglossal nerve stimulation (HNS) and continuous transcutaneous electrical stimulation (CTES), are currently emerging. We report on patients' preference for different treatments of OSA.
We recorded patients' age, gender, body mass index (BMI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire with 10 questions (FOSQ10), severity of OSA, and current treatment. We showed pictures of existing [CPAP, mandibular advancement device (MAD)] and emerging treatments (HNS and CTES). We then asked (I) whether participants were interested in further information about HNS/CTES; (II) if they would be willing to try HNS/CTES; and (III) if they were to choose only one of the four listed treatments, which one would they prefer to use every night.
One hundred sixty-two patients completed the survey {81 males, mean age 52 [12] years, BMI 34 [7] kg/m(2), ESS 10.2 (6.0) points, FOSQ10 28.5 (8.1) points}. The majority of the respondents (89.5%) had been diagnosed with OSA. A total of 91.3% of the respondents were interested in more information and were willing to try HNS/CTES. Most respondents preferred the potential use of CTES (56.7%), while 21.7% chose HNS, 17.8% CPAP, and 3.8% the MAD. There were no differences in the characteristics of the patients who preferred CTES compared to those who preferred other treatments, but a regression analysis revealed that a low ESS score was an independent predictor of patients choosing CTES (P<0.05).
More than 9 out of 10 of the respondents were interested in trying emerging technologies to treat OSA, most preferring CTES. Less sleepy patients were more likely to choose less invasive treatments. These findings will likely impact on future research and development of therapies for sleep-disordered breathing.
阻塞性睡眠呼吸暂停（OSA）是睡眠呼吸障碍最常见的形式。标准治疗方法持续气道正压通气（CPAP）的长期依从性有限。需要其他治疗选择，目前正在出现包括舌下神经刺激（HNS）和持续经皮电刺激（CTES）在内的新方法。我们报告了患者对OSA不同治疗方法的偏好。
我们记录了患者的年龄、性别、体重指数（BMI）、爱泼华嗜睡量表（ESS）、10项睡眠问卷功能结果（FOSQ10）、OSA严重程度和当前治疗方法。我们展示了现有[CPAP、下颌前移装置（MAD）]和新兴治疗方法（HNS和CTES）的图片。然后我们询问（I）参与者是否有兴趣了解有关HNS/CTES的更多信息；（II）他们是否愿意尝试HNS/CTES；以及（III）如果他们只能从列出的四种治疗方法中选择一种，他们每晚更喜欢使用哪一种。
162名患者完成了调查{81名男性，平均年龄52[12]岁，BMI 34[7]kg/m²，ESS 10.2（6.0）分，FOSQ10 28.5（8.1）分}。大多数受访者（89.5%）被诊断患有OSA。共有91.3%的受访者有兴趣了解更多信息并愿意尝试HNS/CTES。大多数受访者倾向于潜在使用CTES（56.7%），而21.7%选择HNS，17.8%选择CPAP，3.8%选择MAD。与偏好其他治疗方法的患者相比，偏好CTES的患者特征没有差异，但回归分析显示ESS得分低是患者选择CTES的独立预测因素（P<0.05）。
超过十分之九的受访者有兴趣尝试新兴技术治疗OSA，大多数人更喜欢CTES。困倦程度较低的患者更有可能选择侵入性较小的治疗方法。这些发现可能会影响睡眠呼吸障碍治疗的未来研发。
