CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
NeuroSleep, National Health and Medical Research Council Centre of Research Excellence, Sydney, Australia.
Eur Respir Rev. 2019 Jun 26;28(152). doi: 10.1183/16000617.0005-2019. Print 2019 Jun 30.
Effective treatment of obstructive sleep apnoea (OSA) is primarily determined by adherence to the selected intervention. The most common treatment pathways are mechanical devices such as continuous positive airway pressure (CPAP) or a mandibular advancement device, often combined with weight loss therapy. Weight reduction is usually an adjunct therapy but may be used as a secondary treatment in mild-to-moderate OSA when mechanical treatments cannot be tolerated. To enhance the uptake and adherence to treatment, clinicians may assess patient's personality profiles and psychological readiness. There is a paucity of evidence related to these aspects of patient care and this article outlines the current research in relation to patient presentation, treatment uptake and barriers, and methods to enhance treatment adherence.This article disseminates personality traits observed in patients with OSA and identifies vulnerable groups who may require additional support to increase treatment adherence. It summarises the current evidence for treatment barriers in patients with OSA. Low self-efficacy in relation to CPAP and weight loss adherence will be explored as well as the potential to predict treatment responders and enhance therapeutic uptake and adherence. Extending personality traits into research and clinical practice could potentially result in more successful CPAP therapy and weight loss treatment outcomes.
阻塞性睡眠呼吸暂停(OSA)的有效治疗主要取决于所选干预措施的依从性。最常见的治疗途径是机械装置,如持续气道正压通气(CPAP)或下颌前伸装置,通常与减肥治疗相结合。减肥通常是一种辅助治疗方法,但在不能耐受机械治疗时,也可作为轻中度 OSA 的二线治疗。为了提高治疗的接受度和依从性,临床医生可以评估患者的人格特征和心理准备情况。关于这些患者护理方面的证据很少,本文概述了与患者就诊、治疗接受度和障碍以及增强治疗依从性的方法相关的当前研究。本文介绍了 OSA 患者观察到的人格特征,并确定了可能需要额外支持以提高治疗依从性的脆弱群体。本文总结了 OSA 患者治疗障碍的现有证据。还将探讨与 CPAP 和减肥依从性相关的自我效能感低的问题,以及预测治疗反应者和增强治疗接受度和依从性的可能性。将人格特征扩展到研究和临床实践中,可能会使 CPAP 治疗和减肥治疗的效果更加成功。