Abdelghani Ahmed, Benzarti Wafa, Ben Salem Hlima, Gargouri Imen, Garrouche Abdelhamid, Hayouni Abdelaziz, Benzarti Mohamed
Tunis Med. 2016 Aug-Sep;94(8-9):551-562.
Continuous positive airway pressure (CPAP) is the most effective treatment for obstructive sleep apnea (OSA). Adequate compliance with the use of CPAP is cardinal to achieve cardiovascular, metabolic and neuropsychological benefits of treatment.
Assess the factors affecting compliance to the CPAP treatment and analyze the long term acceptance.
Retrospective study on 130 patients treated by CPAP for OSA in the department of pulmonology between 2005 and 2014. Long term acceptance was analysis using the method of survival analysis.
These patients are characterized by a mean age of 55.4± 10.2 years; main comorbidities were found hypertension (47%), diabetes (25.5%) and COPD (11%). Median baseline apnea-hypopnea index was (AHI), 56 ± 19,5/h. One hundred thirty patients were enrolled with a mean follow up of 75 ± 34 months, 42 patients stopped their treatment, 21% of them in the first 6 months. In compliant patients, the median value of daily CPAP use was 5, 5 ± 2 hours. Kaplan Meier analysis showed that 96% of patients were still using CPAP at 12 months, 69,4% at 5 years and 64,1% at 10 years. Chronic Obstructive Pulmonary Disease was identified as a predictor factor of long term CPAP use. Non observing patients had a higher probability to stop the use of CPAP compared to adherent patients Conclusion: the treatment of OSA with CPAP is generally well accepted in the long term. Treatment dropouts are more common among non-adherent patients justify regular monitoring in the first months of treatment.
持续气道正压通气（CPAP）是治疗阻塞性睡眠呼吸暂停（OSA）最有效的方法。充分依从CPAP治疗对于获得心血管、代谢及神经心理方面的治疗益处至关重要。
评估影响CPAP治疗依从性的因素并分析长期接受情况。
对2005年至2014年间在呼吸内科接受CPAP治疗OSA的130例患者进行回顾性研究。采用生存分析方法分析长期接受情况。
这些患者的平均年龄为55.4±10.2岁；主要合并症有高血压（47%）、糖尿病（25.5%）和慢性阻塞性肺疾病（COPD，11%）。基线呼吸暂停低通气指数（AHI）中位数为56±19.5次/小时。130例患者入组，平均随访75±34个月，42例患者停止治疗，其中21%在最初6个月内停药。依从性好的患者每日使用CPAP的中位数为5.5±2小时。Kaplan-Meier分析显示，96%的患者在12个月时仍在使用CPAP，5年时为69.4%，10年时为64.1%。慢性阻塞性肺疾病被确定为长期使用CPAP的预测因素。与依从性好的患者相比，不遵守治疗的患者停用CPAP的可能性更高。结论：CPAP治疗OSA长期来看总体接受度良好。治疗中断在不依从患者中更为常见，这证明在治疗的最初几个月进行定期监测是合理的。
