Department of Otorhinolaryngology, Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Clin Sleep Med. 2023 Jan 1;19(1):17-26. doi: 10.5664/jcsm.10236.
Positive airway pressure (PAP) is considered a standard treatment for obstructive sleep apnea (OSA), but there are compliance issues. As compliance to PAP tends to decrease with time, it is necessary to consider reasons affecting compliance at each period. Therefore, this study aimed to define factors affecting short-term and long-term compliance to PAP therapy.
One hundred eighty-seven patients with OSA who started PAP treatment between July 2018 to March 2020 were included. Acceptance and compliance rates were monitored. Demographics, polysomnography (PSG) profiles, cephalometric data, and physical examination results were analyzed to identify factors predictive of PAP compliance at short-term (3 months) and long-term (12 months) periods.
The acceptance rate of PAP was 92.5%. Compliance at 3 months and 12 months was 79.1% and 51.3%, respectively. Higher apnea-hypopnea index (odds ratio [OR] 1.018, = .049) and older age (OR 1.032, = .039) were predictive factors of good automatic PAP (APAP) compliance at 3 months. However, long-term compliance was affected by the percentage of duration with O desaturation of < 90% (CT90; OR 1.032, = .011) and baseline self-reported symptom scores such as nasal obstruction (OR 0.819, = .038) and awakening (OR 0.796, = .045).
In PAP use, indicators of OSA severity such as apnea-hypopnea index affect short-term compliance. On the other hand, the mandibular plane to hyoid distance and self-reported symptoms such as nasal obstruction and awakening can affect long-term compliance.
Park SI, Kim BK, Lee KE, Hong SD, Jung YG, Kim HY. Predictors for short-term and long-term automatic PAP compliance. . 2023;19(1):17-26.
正压通气（PAP）被认为是治疗阻塞性睡眠呼吸暂停（OSA）的标准方法，但存在依从性问题。由于 PAP 的依从性随着时间的推移而降低，因此有必要在每个时期考虑影响依从性的原因。因此，本研究旨在确定影响 PAP 治疗短期和长期依从性的因素。
纳入 2018 年 7 月至 2020 年 3 月期间开始 PAP 治疗的 187 例 OSA 患者。监测接受率和依从率。分析人口统计学、多导睡眠图（PSG）特征、头影测量数据和体格检查结果，以确定短期（3 个月）和长期（12 个月）PAP 依从性的预测因素。
PAP 的接受率为 92.5%。3 个月和 12 个月的依从率分别为 79.1%和 51.3%。较高的呼吸暂停低通气指数（比值比 [OR] 1.018，.049）和年龄较大（OR 1.032，.039）是 3 个月时良好自动 PAP（APAP）依从性的预测因素。然而，长期依从性受 CT90（OR 1.032，.011）和基线自我报告症状评分（如鼻塞[OR 0.819，.038]和觉醒[OR 0.796，.045]）的影响。
在 PAP 使用中，OSA 严重程度的指标，如呼吸暂停低通气指数，会影响短期依从性。另一方面，下颌平面到舌骨距离和自我报告的症状，如鼻塞和觉醒，可能会影响长期依从性。
Park SI, Kim BK, Lee KE, Hong SD, Jung YG, Kim HY. 短期和长期自动 PAP 依从性的预测因素。睡眠呼吸 2023;19(1):17-26.
