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季节性因素对阻塞性睡眠呼吸暂停患者持续气道正压通气治疗依从性的影响。

Seasonal effects on the continuous positive airway pressure adherence of patients with obstructive sleep apnea.

机构信息

Environmental Health Nursing, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53, Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan; Center for Sleep Medicine, Ehime University Hospital, 454, Toon-city, Ehime, 791-0204, Japan.

Center for Sleep Medicine, Ehime University Hospital, 454, Toon-city, Ehime, 791-0204, Japan.

出版信息

Sleep Med. 2021 Apr;80:126-133. doi: 10.1016/j.sleep.2021.01.024. Epub 2021 Jan 29.

DOI:10.1016/j.sleep.2021.01.024
PMID:33596526
Abstract

OBJECTIVE

This study examined seasonal differences in continuous positive airway pressure (CPAP) therapy adherence among patients with obstructive sleep apnea (OSA).

METHODS

Patients aged ≥20 years with OSA who had used CPAP devices on the automatic setting for >12 consecutive months (n = 141) were included in this retrospective study from December 2015-2016. The information of CPAP use (pressure, hours of actual use) was extracted from database downloaded from patients' CPAP devices. Patients were divided into adherent and non-adherent groups using the cutoff point of 70% CPAP use for ≥4 h daily over the 1-year study period. CPAP use data were averaged for each season.

RESULTS

Patients in the adherent group were significantly older than those in the non-adherent group (p < 0.001). In the adherent group, the rate of ≥4 h daily CPAP use was significantly lower, the daily duration of CPAP use was significantly shorter, and the residual apnea-hypopnea index (AHI; events/hour) was significantly higher in summer than in other seasons (all p < 0.001). In the non-adherent group, the duration of daily CPAP use and the AHI differed significantly between winter and summer (p = 0.008 and p < 0.001, respectively).

CONCLUSIONS

Seasonal changes were associated with the CPAP adherence of patients with OSA. The study findings suggest that there is possibility of increasing the duration of CPAP use by adjusting the bedroom environment in hot and humid seasons.

摘要

目的

本研究旨在探讨阻塞性睡眠呼吸暂停(OSA)患者持续气道正压通气(CPAP)治疗依从性的季节性差异。

方法

本回顾性研究纳入了 2015 年 12 月至 2016 年期间使用自动设置 CPAP 设备且连续使用>12 个月的≥20 岁 OSA 患者(n=141)。从患者 CPAP 设备中下载数据库以提取 CPAP 使用信息(压力、实际使用时间)。将 CPAP 使用时间≥70%且每日≥4 小时的患者定义为依从组,否则为不依从组。将 CPAP 使用数据平均到每个季节。

结果

依从组患者明显比不依从组患者年龄大(p<0.001)。在依从组中,夏季每日 CPAP 使用时间显著较短(p<0.001),每日 CPAP 使用时间显著较短(p<0.001),残留的呼吸暂停低通气指数(AHI;事件/小时)显著较高(均 p<0.001)。在不依从组中,冬季和夏季每日 CPAP 使用时间和 AHI 差异显著(p=0.008 和 p<0.001)。

结论

季节性变化与 OSA 患者的 CPAP 依从性相关。研究结果表明,通过调整炎热和潮湿季节的卧室环境,有可能增加 CPAP 的使用时间。

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