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中重度阻塞性睡眠呼吸暂停低通气综合征患者短期 CPAP 治疗的影响:一项随机双盲临床试验。

Impact of CPAP treatment for a short period in moderate-to-severe OSAS patients: a randomized double-blind clinical trial.

机构信息

Universidade Estadual Paulista (UNESP), Faculdade de Medicina, Fundamentos de Cirurgia, Botucatu, SP, Brazil.

Universidade Estadual Paulista (UNESP), Faculdade de Medicina, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Botucatu, SP, Brazil.

出版信息

Braz J Otorhinolaryngol. 2022 Nov-Dec;88(6):917-924. doi: 10.1016/j.bjorl.2020.12.011. Epub 2021 Jan 21.

Abstract

INTRODUCTION

Obesity is the most frequent reversible agravating factor of obstructive sleep apnea syndrome, with physical activity very important for its control. Continuous positive air pressure during sleep is the "gold standard" treatment for obstructive sleep apnea syndrome.

OBJECTIVE

we aimed to investigate if the use of continuous positive air pressure for a short period (7 days), would improve sleep quality, daytime sleepiness, and the disposition for physical activity.

METHODS

Eighty obstructive sleep apnea syndrome patients were randomly assigned as follows: group I - continuous positive air pressure with a steady pressure of 4 cm HO; group II - ideal therapeutic pressure. After filling out the questionnaires related to the studied variables (International physical activity questionnaire long-form, Epworth sleepiness scale, Pittsburgh sleep quality index), patients underwent a baseline pulmonary function test and continuous positive air pressure titration. After continuous positive air pressure therapy for 4≥ hours a night for 7 consecutive days, patients returned and filled out new (International physical activity questionnaire long-form, Epworth sleepiness scale, Pittsburgh sleep quality index) forms. New spirometry was carried out.

RESULTS

39 patients completed the study. The mean age was 52 ± 11 years old and 28 patients (71.79%) were obese. Both groups were similar for all variables studied at baseline. After Continuous positive air pressure use, patients of group II presented more significant improvements (p <  0.05) for sleep quality and diurnal sleepiness. Time spent with physical activities did not change. Spirometric data were at normal range at baseline. Solely the variable FEF 25%-75% was significantly enhanced (p <  0.05) in group II.

CONCLUSION

Continuous positive air pressure therapy for 1 week, with ideal pressure, improves daytime sleepiness and sleep quality, enhances pulmonary function, but does not change the mean time spent with physical activities.

摘要

引言

肥胖是阻塞性睡眠呼吸暂停综合征最常见的可逆转加重因素,而体力活动对其控制非常重要。睡眠时持续气道正压通气是阻塞性睡眠呼吸暂停综合征的“金标准”治疗方法。

目的

我们旨在研究使用持续气道正压通气(CPAP)短时间(7 天)是否可以改善睡眠质量、日间嗜睡和体力活动倾向。

方法

80 例阻塞性睡眠呼吸暂停综合征患者被随机分为以下两组:I 组 - 持续气道正压通气,稳定压力为 4cmH2O;II 组 - 理想治疗压力。在填写与研究变量相关的问卷(国际体力活动问卷长式、埃普沃斯嗜睡量表、匹兹堡睡眠质量指数)后,患者进行基线肺功能测试和持续气道正压通气滴定。在连续 7 天每晚 4 小时以上接受 CPAP 治疗后,患者返回并填写新的(国际体力活动问卷长式、埃普沃斯嗜睡量表、匹兹堡睡眠质量指数)表格。进行新的肺功能检查。

结果

39 例患者完成了研究。平均年龄为 52±11 岁,28 例患者(71.79%)肥胖。两组在基线时所有研究变量均相似。使用 CPAP 后,II 组患者的睡眠质量和日间嗜睡有更显著的改善(p<0.05)。体力活动时间没有变化。肺功能数据在基线时处于正常范围。仅 II 组的 FEF 25%-75%变量显著增强(p<0.05)。

结论

用理想压力进行 1 周 CPAP 治疗可改善日间嗜睡和睡眠质量,增强肺功能,但不会改变平均体力活动时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ea9/9615516/93e9412f8f96/gr1.jpg

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