Shaukat Rabia, Gamal Yasser, Ali Ahlam, Mohamed Sherif
Department of Family and Community Medicine, UTHealth Science Center, Houston, USA.
Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, EGY.
Cureus. 2022 Jun 14;14(6):e25946. doi: 10.7759/cureus.25946. eCollection 2022 Jun.
Adherence to either continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) therapy in patients with obstructive sleep apnea syndrome (OSAS) represents a real challenge to sleep medicine physicians. Many risk factors/predictors for nonadherence exist, and usually, it is multifactorial. Long-term nonadherence with CPAP therapy has been associated with the use of CPAP for <4 hours/night during early treatment, moderate to severe obstructive sleep apnea (OSA), poor self-efficacy, and unsupportive bed partner. The American Academy of Sleep Medicine (AASM) recommends follow-up of patients with OSA within the first two weeks of CPAP use to optimize adherence. Measures to improve adherence to positive airway pressure (PAP) therapy go through an integrated approach that involves behavioral therapy and prompt management of side effects. Pharmacologic therapy in the form of a sedative-hypnotic sleep aid has a minor role in managing nonadherence to CPAP based on the greater risk of side effects. This article will briefly discuss the risk factors and management of nonadherence to PAP therapy in patients with OSAS.
对于阻塞性睡眠呼吸暂停综合征（OSAS）患者而言，坚持持续气道正压通气（CPAP）治疗或双水平气道正压通气（BiPAP）治疗对睡眠医学医生来说是一项切实的挑战。存在许多导致不依从的风险因素/预测指标，而且通常是多因素的。长期不坚持CPAP治疗与早期治疗期间每晚使用CPAP不足4小时、中重度阻塞性睡眠呼吸暂停（OSA）、自我效能差以及伴侣不支持有关。美国睡眠医学学会（AASM）建议在使用CPAP的头两周内对OSA患者进行随访，以优化依从性。提高对气道正压通气（PAP）治疗依从性的措施需通过一种综合方法，该方法包括行为疗法和对副作用的及时处理。基于副作用风险更大，以镇静催眠助眠药物形式的药物治疗在处理不坚持CPAP治疗方面作用较小。本文将简要讨论OSAS患者不坚持PAP治疗的风险因素及处理方法。
