Liao Wen-Jing, Song Li-Juan, Yi Hong-Liang, Guan Jian, Zou Jian-Yin, Xu Hua-Jun, Wang Gang, Ma Fei, Zhou Li-Bo, Chen Yu-Qing, Yan Li-Bo, Deng Zhi-Cheng, McNicholas Walter T, Yin Shan-Kai, Zhong Nan-Shan, Zhang Xiao-Wen
State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, Laboratory of ENT-HNS Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
Department of Otolaryngology Head and Neck Surgery & Center for Sleep Medicine, Sixth Affiliated People's Hospital of Shanghai Jiao Tong University, Shanghai 200233, China.
J Thorac Dis. 2018 Mar;10(3):1941-1950. doi: 10.21037/jtd.2018.03.135.
Standard management has been recommended for obstructive sleep apnea (OSA) by several guidelines, but patient choice in the practical setting is unclear.
A survey nested in two prospective cohort studies of OSA (enrollment: 2001-2010) in China. The last interview was conducted between July 2014 and May 2015, using a comprehensive 10-point questionnaire administered in a face-to-face or telephone interview, and assessed (I) whether the participant had received any OSA treatment; (II) why he or she had decided for or against treatment; (III) what treatment was received; (IV) whether the participant used continuous positive airway pressure (CPAP) or OA daily; and (V) the perceived efficacy of therapy.
A total of 4,097 subjects with a mean age of 45 years [37-55] responded to this survey, with a response rate of 79.4% (4,097/5,160); 2,779 subjects (67.8%) did not receive any treatment: 1,485 (53.4%) believed that their condition was not serious, despite severe OSA in 53.7% of the patients. A multivariate regression showed that the decision to receive treatment was associated with: age between 45-59 years [odds ratio (OR) 0.805, 95% CI: 0.691-0.936; P<0.001], female gender (OR 0.492, 95% CI: 0.383-0.631; P<0.001), severe OSA (OR 1.92, 95% CI: 1.01-3.64; P<0.001), hypertension (OR 1.414, 95% CI: 1.209-1.654; P<0.001) and diabetes (OR 1.760, 95% CI: 1.043-2.972; P=0.034). In subjects receiving treatment (n=1,318), 50.9% reported negative perceptions about the treatments.
Nearly two thirds of Chinese patients choose not to receive treatment after OSA diagnosis, and nearly half are negative about their treatments for OSA. This requires clinical attention, and warrants further study in different geographic settings.
多项指南推荐了阻塞性睡眠呼吸暂停（OSA）的标准管理方法，但在实际临床中患者的选择尚不明确。
一项调查嵌套于中国两项OSA前瞻性队列研究（入组时间：2001 - 2010年）中。末次访谈于2014年7月至2015年5月进行，采用一份10项全面问卷，通过面对面或电话访谈方式进行，并评估：（I）参与者是否接受过任何OSA治疗；（II）其决定接受或不接受治疗的原因；（III）接受了何种治疗；（IV）参与者是否每天使用持续气道正压通气（CPAP）或口腔矫治器（OA）；以及（V）治疗的感知疗效。
共有4097名平均年龄为45岁[37 - 55岁]的受试者回应了此次调查，回应率为79.4%（4097/5160）；2779名受试者（67.8%）未接受任何治疗：1485名（53.4%）认为自身病情不严重，尽管53.7%的患者患有重度OSA。多因素回归分析显示，接受治疗的决定与以下因素相关：年龄在45 - 59岁之间[比值比（OR）0.805，95%置信区间（CI）：0.691 - 0.936；P < 0.001]、女性（OR 0.492，95% CI：0.383 - 0.631；P < 0.001）、重度OSA（OR 1.92，95% CI：1.01 - 3.64；P < 0.001）、高血压（OR 1.414，95% CI：1.209 - 1.654；P < 0.001）和糖尿病（OR 1.760，95% CI：1.043 - 2.972；P = 0.034）。在接受治疗的受试者（n = 1318）中，50.9%报告对治疗有负面看法。
近三分之二的中国患者在被诊断为OSA后选择不接受治疗，且近一半患者对其OSA治疗持负面看法。这需要临床关注，并值得在不同地理区域进一步研究。
