Faculty of Medicine, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Faculty of Medicine, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Sleep Med. 2022 Oct;98:139-143. doi: 10.1016/j.sleep.2022.06.017. Epub 2022 Jul 2.
OBJECTIVE/BACKGROUND: Despite many years of research, multiple factors have inconsistently shown to be associated with positive airway pressure (PAP) adherence. We conducted a retrospective observational study to evaluate the association between selected demographics, obstructive sleep apnea (OSA) - and generally available PAP treatment-related factors with objective PAP therapy adherence.
PATIENTS/METHODS: We considered all consented individuals with OSA who purchased a PAP device from a registered vendor (Ottawa, Ontario) between 2011 and 2017 who had usage data available (n = 11,614). PAP adherence was measured objectively as PAP use for at least 4 h on at least 70% of days on treatment.
In our cohort, 7147 (61.5%) participants were deemed adherent to PAP over a median of 214 days (IQR: 84-675). The median percentage of days PAP therapy was used was 82% (IQR: 48-97%), and the median number of days PAP therapy was used for greater than 4 h was 95 (IQR: 28-372). In multivariable logistic regression considering all variables available, increased body mass index, older age, and lower minimum SaO at baseline sleep study were significantly associated with increased PAP adherence. Individuals who were using PAP longer and with greater adherence during the first month were subsequently more adherent to therapy. We also found a different predictive ability of PAP adherence-related factors by age and sex.
In this retrospective community-based longitudinal observational study, we identified readily available demographics and OSA-related factors associated with PAP adherence. We also confirmed previous findings on age and sex disparities in adherence to PAP.
目的/背景：尽管经过多年研究，仍有多个因素与正压通气（PAP）治疗的依从性不一致相关。我们进行了一项回顾性观察研究，以评估选定的人口统计学、阻塞性睡眠呼吸暂停（OSA）和一般可用的 PAP 治疗相关因素与客观 PAP 治疗依从性之间的关联。
患者/方法：我们考虑了所有在 2011 年至 2017 年间从注册供应商（安大略省渥太华）购买 PAP 设备且有可用使用数据（n=11614）的同意参与者。PAP 依从性通过在治疗期间至少 70%的日子中每天使用 PAP 至少 4 小时来客观衡量。
在我们的队列中，7147（61.5%）名参与者在中位数为 214 天（IQR：84-675）的时间内被认为对 PAP 治疗依从。PAP 治疗使用的天数中位数为 82%（IQR：48-97%），PAP 治疗使用的天数中位数大于 4 小时为 95 天（IQR：28-372）。在考虑所有可用变量的多变量逻辑回归中，较高的体重指数、年龄较大和基线睡眠研究中的最低 SaO2 与增加的 PAP 依从性显著相关。在第一个月内使用 PAP 时间更长和依从性更高的患者随后对治疗的依从性更高。我们还发现了与 PAP 依从性相关的因素在年龄和性别方面的不同预测能力。
在这项回顾性基于社区的纵向观察研究中，我们确定了与 PAP 依从性相关的现成的人口统计学和 OSA 相关因素。我们还证实了以前关于年龄和性别对 PAP 依从性差异的发现。
