Schwarz Esther I, Stradling John R, Kohler Malcolm
Sleep Disorders Center and Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland.
National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust and University of Oxford, Oxford, UK.
J Thorac Dis. 2018 Jan;10(Suppl 1):S24-S32. doi: 10.21037/jtd.2017.12.142.
Randomised controlled trials (RCTs) of continuous positive airway pressure (CPAP) in obstructive sleep apnoea (OSA) are time consuming, and their findings often inconclusive or limited due to suboptimal CPAP adherence in CPAP-naïve patients with OSA. Short-term CPAP withdrawal in patients with prior optimal CPAP adherence results in recurrence of OSA and its consequences. Thus, this experimental model serves as an efficient tool to investigate both the consequences of untreated OSA, and potential treatment alternatives to CPAP. The CPAP withdrawal protocol has been thoroughly validated, and applied in several RCTs focusing on cardiovascular and metabolic consequences of untreated OSA, as well as the assessment of treatment alternatives to CPAP.
持续气道正压通气（CPAP）治疗阻塞性睡眠呼吸暂停（OSA）的随机对照试验（RCT）耗时较长，而且由于初治的OSA患者对CPAP的依从性欠佳，其研究结果往往尚无定论或存在局限性。既往CPAP依从性良好的患者短期停用CPAP会导致OSA复发及其相关后果。因此，该实验模型是一种有效的工具，可用于研究未经治疗的OSA的后果以及CPAP的潜在替代治疗方法。CPAP撤机方案已得到充分验证，并应用于多项RCT中，这些研究聚焦于未经治疗的OSA的心血管和代谢后果，以及CPAP替代治疗的评估。
