Jeong Jong In, Kim Hyo Yeol, Hong Sang Duk, Ryu Gwanghui, Kim Su Jin, Lee Kyung Eun, Dhong Hun-Jong, Chung Seung-Kyu
Department of Otolaryngology, Keimyung University School of Medicine, Daegu, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Clin Exp Otorhinolaryngol. 2016 Dec;9(4):346-351. doi: 10.21053/ceo.2015.01984. Epub 2016 Jun 18.
Compliance with continuous positive airway pressure (CPAP) treatment remains a primary concern for improving treatment outcomes of obstructive sleep apnea. There are few studies that have considered the role of upper airway anatomy on the compliance with CPAP. We hypothesized that upper airway anatomy would influence the compliance with CPAP.
One hundred out of 161 consecutive patients were enrolled in this study. The following possible determinants were tested against CPAP use: demographic and anthropometric data, minimal cross-sectional area on acoustic rhinometry, cephalometric and polysomnographic data, questionnaires of Epworth sleepiness scale and Beck depression index, and histories of previous upper airway surgery, degree of nasal obstruction, daily cigarette consumption, and weekly frequency of alcohol intake.
Univariate analysis showed that histories of previous upper airway surgery and less frequent alcohol consumption, and longer mandibular plane-hyoid length (MP-H) on cephalometry were associated with longer average daily CPAP use. After adjustment for the confounding factors with multiple linear regression analysis, alcohol consumption and MP-H were still associated with the compliance with CPAP significantly.
To improve compliance with CPAP, careful evaluations of upper airway problems and life style are important before initiating CPAP.
持续气道正压通气（CPAP）治疗的依从性仍然是改善阻塞性睡眠呼吸暂停治疗效果的主要关注点。很少有研究考虑上气道解剖结构对CPAP依从性的作用。我们假设上气道解剖结构会影响CPAP的依从性。
在161例连续患者中纳入100例进行本研究。针对CPAP使用情况测试了以下可能的决定因素：人口统计学和人体测量数据、鼻声反射测量的最小横截面积、头影测量和多导睡眠图数据、Epworth嗜睡量表和贝克抑郁指数问卷，以及既往上气道手术史、鼻阻塞程度、每日吸烟量和每周饮酒频率。
单因素分析显示，既往上气道手术史、饮酒频率较低以及头影测量中下颌平面-舌骨长度（MP-H）较长与每日平均CPAP使用时间较长相关。在通过多元线性回归分析调整混杂因素后，饮酒量和MP-H仍与CPAP依从性显著相关。
为提高CPAP依从性，在开始CPAP治疗前对上气道问题和生活方式进行仔细评估很重要。
