Clinique du Sommeil, Service d'Explorations Fonctionnelles du Système Nerveux, CHU de Bordeaux, Bordeaux, France.
Univ. Bordeaux, SANPSY, Bordeaux, France.
PLoS One. 2018 Apr 4;13(4):e0195343. doi: 10.1371/journal.pone.0195343. eCollection 2018.
This study explores the association between specific insomnia symptoms (sleep onset, sleep maintenance and early morning awakenings symptoms) and self-efficacy (perceived self-confidence in the ability to use CPAP) with CPAP compliance in French patients with obstructive sleep apnea syndrome (OSAS). We performed a retrospective, cross-sectional analysis of CPAP compliance in a cohort of 404 patients diagnosed with OSAS. Patients completed mailed questionnaires on sleepiness (ESS), insomnia (ISI) and self-efficacy in sleep apnea (SEMSA). Linear regression modeling analyses were performed to explore the impact of measured variables on the number of hours of CPAP use. Of the initial pool of 404 patients, 288 returned the questionnaires (71% response rate). Their mean age was 63.16±12.73 yrs, 31% were females, mean BMI was 30.39±6.31 kg/m2, mean daily CPAP use was 6.19±2.03 h, mean number of years of use was 6.58±6.03 yrs, and mean initial AHI before CPAP use was 34.61±20.71 /h. Age (p<0.01), BMI (p<0.01), sleep onset insomnia symptoms (p<0.01), sleep maintenance insomnia symptoms (p<0.01) and self-efficacy (p<0.01) were significantly associated with mean daily CPAP use. We found that specific insomnia symptoms and self-efficacy were associated with CPAP compliance. Our findings underline the need to demonstrate that interventions that reduce insomnia symptoms and improve self-efficacy will increase CPAP compliance.
本研究旨在探讨特定的失眠症状（入睡、睡眠维持和清晨觉醒症状）和自我效能（对使用 CPAP 的能力的自我感知信心）与法国阻塞性睡眠呼吸暂停综合征（OSAS）患者 CPAP 依从性之间的关联。我们对 404 例确诊为 OSAS 的患者进行了 CPAP 依从性的回顾性、横断面分析。患者完成了关于嗜睡（ESS）、失眠（ISI）和睡眠呼吸暂停自我效能（SEMSA）的邮寄问卷。线性回归模型分析用于探索测量变量对 CPAP 使用时间的影响。在最初的 404 名患者中，有 288 名患者返回了问卷（71%的回复率）。他们的平均年龄为 63.16±12.73 岁，31%为女性，平均 BMI 为 30.39±6.31kg/m2，平均每日 CPAP 使用时间为 6.19±2.03 小时，平均 CPAP 使用年限为 6.58±6.03 年，初始 CPAP 使用前的平均 AHI 为 34.61±20.71/h。年龄（p<0.01）、BMI（p<0.01）、入睡性失眠症状（p<0.01）、睡眠维持性失眠症状（p<0.01）和自我效能（p<0.01）与平均每日 CPAP 使用时间显著相关。我们发现，特定的失眠症状和自我效能与 CPAP 依从性相关。我们的研究结果强调需要证明可以减少失眠症状和提高自我效能的干预措施将提高 CPAP 的依从性。
