Aro Miia M, Anttalainen Ulla, Polo Olli, Saaresranta Tarja
Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, Turku, Finland.
Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland.
Eur Clin Respir J. 2021 Feb 17;8(1):1888394. doi: 10.1080/20018525.2021.1888394.
The prevalence of obstructive sleep apnoea syndrome (OSAS) keeps on rising. Daytime sleepiness resulting from fragmented sleep is the prime symptom, and obesity the major risk factor for OSAS. Quality of life with OSAS is often affected by depressive symptoms and anxiety. Nasal continuous positive airway pressure (CPAP) therapy reduces daytime sleepiness, but the results on the effect on mood, physical activity, and weight are controversial especially on long-term therapy. Purpose of this study was to evaluate these factors and predictors of weight gain during long-term CPAP therapy. Consecutive patients (n = 223), referred to sleep study with suspected OSAS, were enrolled. Patients underwent a cardiorespiratory polygraphy at baseline and a battery of questionnaires was completed, both at baseline, and after three years of follow-up. Total of 149 (67%; M 65, F 84) patients completed the follow-up. Of the 149 patients, 76 (51.0%; M 32, F 44) used CPAP. In this study, depressive symptoms, anxiety, and sleepiness were alleviated during CPAP therapy. However, therapy did not have an influence on cravings of different food categories, or exercise habits and exercise duration. From the various factors studied, solely higher adherence to CPAP therapy was associated with weight gain. This research provides further evidence that long-term CPAP therapy in patients with OSAS not only decreases sleepiness and improves sleep quality but could also alleviate depressive symptoms and anxiety. In addition, our study reinforces that CPAP therapy alone is not sufficient for weight management in patients with OSAS. Regardless of comprehensive battery of questionnaires, we were unable to establish markers predicting weight gain during therapy. We advise on life-style counselling and weight management program to all patients with obesity on CPAP therapy.
阻塞性睡眠呼吸暂停综合征（OSAS）的患病率持续上升。睡眠碎片化导致的日间嗜睡是主要症状，肥胖是OSAS的主要危险因素。OSAS患者的生活质量常受抑郁症状和焦虑的影响。鼻持续气道正压通气（CPAP）治疗可减轻日间嗜睡，但对情绪、身体活动和体重的影响结果存在争议，尤其是长期治疗时。本研究的目的是评估这些因素以及长期CPAP治疗期间体重增加的预测因素。纳入了连续223例因疑似OSAS而转诊进行睡眠研究的患者。患者在基线时接受了心肺多导睡眠监测，并在基线及随访三年后完成了一系列问卷调查。共有149例（67%；男性65例，女性84例）患者完成了随访。在这149例患者中，76例（51.0%；男性32例，女性44例）使用了CPAP。在本研究中，CPAP治疗期间抑郁症状、焦虑和嗜睡得到缓解。然而，治疗对不同食物类别的渴望、运动习惯和运动时长没有影响。在所研究的各种因素中，仅较高的CPAP治疗依从性与体重增加有关。这项研究进一步证明，OSAS患者长期CPAP治疗不仅可减轻嗜睡并改善睡眠质量，还可缓解抑郁症状和焦虑。此外，我们的研究强化了单独的CPAP治疗不足以对OSAS患者进行体重管理这一观点。尽管使用了全面的问卷调查，但我们无法确定预测治疗期间体重增加的指标。我们建议对所有接受CPAP治疗的肥胖患者进行生活方式咨询和体重管理计划。
