Hoshino Tetsuro, Sasanabe Ryujiro, Tanigawa Tohru, Murotani Kenta, Arimoto Mariko, Ueda Hiromi, Shiomi Toshiaki
1 Department of Otorhinolaryngology, Aichi Medical University School of Medicine, Nagakute, Japan.
2 Department of Sleep Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
J Int Med Res. 2018 Jun;46(6):2238-2248. doi: 10.1177/0300060518758583. Epub 2018 Apr 3.
Objective Rapid eye movement (REM)-related obstructive sleep apnea (OSA) is characterized by respiratory events such as apnea and hypopnea predominately or exclusively during REM sleep. Several studies have revealed clinical predictors of adherence to the use of continuous positive airway pressure (CPAP). However, the effect of REM-related OSA on adherence to CPAP use remains unclear. Therefore, we investigated the effects of REM-related OSA on adherence to CPAP use 6 months after treatment initiation. Methods We enrolled 161 patients in this study and divided them into 3 groups: the good adherence, poor adherence, and dropout groups. We compared polysomnographic data and clinical findings, including those regarding morbidity of REM-related OSA, among the three groups to identify predictors of adherence to CPAP use. Results None of the 43 patients in the good adherence group had REM-related OSA. Multivariate logistic regression analysis of the good adherence and dropout groups indicated that REM-related OSA was the only factor associated with adherence to CPAP use (odds ratio, 41.984; 95% confidence interval, 2.257-781.007). Conclusions REM-related OSA is a reliable risk factor for dropout from CPAP therapy.
目的 快速眼动（REM）相关阻塞性睡眠呼吸暂停（OSA）的特征是呼吸事件，如主要或仅在快速眼动睡眠期间出现的呼吸暂停和呼吸不足。多项研究揭示了持续气道正压通气（CPAP）使用依从性的临床预测因素。然而，REM相关OSA对CPAP使用依从性的影响仍不明确。因此，我们在治疗开始6个月后调查了REM相关OSA对CPAP使用依从性的影响。方法 我们招募了161名患者参与本研究，并将他们分为3组：良好依从性组、不良依从性组和退出组。我们比较了三组之间的多导睡眠图数据和临床发现，包括与REM相关OSA发病率有关的数据，以确定CPAP使用依从性的预测因素。结果 良好依从性组的43名患者中无一例患有REM相关OSA。对良好依从性组和退出组进行多因素逻辑回归分析表明，REM相关OSA是与CPAP使用依从性相关的唯一因素（比值比，41.984；95%置信区间，2.257 - 781.007）。结论 REM相关OSA是CPAP治疗退出的可靠危险因素。
