Bikov Andras, Khalil Safia, Gibbons Meg, Bentley Andrew, Jones David, Bokhari Saba
Regional Sleep Service, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK.
Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester M23 9LT, UK.
J Clin Med. 2021 Sep 22;10(19):4310. doi: 10.3390/jcm10194310.
The COVID-19 pandemic led to significant delays in the diagnostic and management pathway of patients with obstructive sleep apnoea (OSA). During the first wave of COVID-19, our department adopted a fully remote diagnostic (home cardiorespiratory polygraphy) and treatment (autoset continuous positive airway pressure, CPAP) approach. As a novel mode of service delivery, our aim was to evaluate our pathway and analyse factors associated with adherence to CPAP. We analysed the first 300 patients (51 ± 13 years, 48% men) who were set up on remote CPAP between 20 May 2020 and 11 September 2020. The associations between CPAP usage at 90 days and age, gender, body mass index, disease severity, Epworth Sleepiness Scale and comorbidities were investigated with linear and logistic regression analyses. A total of 124 patients (41.3%) were fully-adherent to CPAP therapy, defined as CPAP usage ≥ 4 h on ≥ 70% of the days. Only driving status was associated with adherence to CPAP. Patients who were adherent at 28 days were more likely to stay adherent at 90 days (3.77 odd ratio /3.10-4.45/ 95% confidence interval). We have shown that a fully remote diagnostic and treatment pathway for patients with OSA can be successfully delivered, and our preliminary outcomes of adherence to CPAP are comparable with published data.
新冠疫情导致阻塞性睡眠呼吸暂停（OSA）患者的诊断和管理流程出现显著延迟。在新冠疫情的第一波期间，我们科室采用了完全远程的诊断（家庭心肺多导睡眠监测）和治疗（自动调压持续气道正压通气，CPAP）方法。作为一种新型的服务提供模式，我们的目的是评估我们的流程并分析与CPAP依从性相关的因素。我们分析了2020年5月20日至2020年9月11日期间开始接受远程CPAP治疗的前300例患者（年龄51±13岁，48%为男性）。通过线性和逻辑回归分析研究了90天时CPAP使用情况与年龄、性别、体重指数、疾病严重程度、爱泼华嗜睡量表及合并症之间的关联。共有124例患者（41.3%）完全依从CPAP治疗，定义为在≥70%的天数里CPAP使用时间≥4小时。只有驾驶状态与CPAP依从性相关。28天时依从的患者在90天时更有可能保持依从（比值比3.77/3.10 - 4.45/95%置信区间）。我们已经表明，OSA患者的完全远程诊断和治疗流程可以成功实施，并且我们关于CPAP依从性的初步结果与已发表的数据相当。
