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不同夫妻群体中持续气道正压通气(CPAP)治疗睡眠呼吸暂停的多维评估

Multidimensional Evaluation of Continuous Positive Airway Pressure (CPAP) Treatment for Sleep Apnea in Different Clusters of Couples.

作者信息

Mendelson Monique, Gentina Thibaut, Gentina Elodie, Tamisier Renaud, Pépin Jean-Louis, Bailly Sébastien

机构信息

HP2 laboratory, INSERM U1042, University Grenoble Alpes, 38000 Grenoble, France.

Ramsay General Healthcare, 59800 Lille, France.

出版信息

J Clin Med. 2020 Jun 1;9(6):1658. doi: 10.3390/jcm9061658.

Abstract

Continuous positive airway pressure (CPAP) is the most efficient treatment of obstructive sleep apnea (OSA). Little is known about the impact of spousal relationship profiles on CPAP adherence. We aimed to identify clusters of couples of OSA patients, and their association with CPAP adherence 120 days after CPAP initiation. In a multicenter prospective study, OSA patients recently prescribed CPAP were enrolled with their spouses. Data about spousal relationships were collected at inclusion and at day 120. Latent class analysis was performed to determine homogeneous groups of spousal relationships. The 290 participants were predominantly males (77%), median age was 53 years and interquartile range (IQR) 46-62, median body mass index (BMI) was 32 kg/m² (IQR: 28.6-35.9) and median apnea-hypopnea index: 43 events per hour (IQR: 33-58). Three couple clusters were identified: 1) older retired couples, 2) young working couples, and 3) mature active couples. Patients in the older retired couples cluster presented the highest CPAP adherence ( < 0.01) independently of initial complaints, OSA severity, and degree of improvement under CPAP. In a large cohort of OSA patients in whom clusters of couples were determined, there was a significant difference in CPAP adherence at day-120 after CPAP initiation.

摘要

持续气道正压通气(CPAP)是阻塞性睡眠呼吸暂停(OSA)最有效的治疗方法。关于配偶关系模式对CPAP依从性的影响,人们了解甚少。我们旨在识别OSA患者夫妇的类别,以及它们与CPAP开始使用120天后依从性的关联。在一项多中心前瞻性研究中,最近开始使用CPAP的OSA患者及其配偶被纳入研究。在纳入时和第120天收集有关配偶关系的数据。进行潜在类别分析以确定配偶关系的同质组。290名参与者主要为男性(77%),年龄中位数为53岁,四分位间距(IQR)为46 - 62岁,体重指数(BMI)中位数为32 kg/m²(IQR:28.6 - 35.9),呼吸暂停低通气指数中位数为每小时43次事件(IQR:33 - 58)。识别出了三类夫妇:1)年长的退休夫妇,2)年轻的在职夫妇,3)成熟活跃的夫妇。年长退休夫妇组的患者CPAP依从性最高(<0.01),与初始症状、OSA严重程度以及CPAP治疗下的改善程度无关。在一个确定了夫妇类别的大型OSA患者队列中,CPAP开始使用120天后的CPAP依从性存在显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d41f/7356867/2fc45e9bb74b/jcm-09-01658-g001.jpg

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