Centre for Research and Development, Uppsala University, Region of Gävleborg, Gävle Hospital, Gävle, Sweden.
Department of Otorhinolaryngology, Head and Neck Cancer, Uppsala University, Uppsala, Sweden.
J Clin Sleep Med. 2023 Mar 1;19(3):453-458. doi: 10.5664/jcsm.10364.
Persons with Down syndrome (DS) have an increased risk of obstructive sleep apnea (OSA) needing continuous positive airway pressure (CPAP), but data on the therapy and outcomes in this population are scarce. We aimed to compare patient characteristics and outcomes of CPAP treatment for patients with OSA with and without DS.
This was a population-based, longitudinal study on patients initiating CPAP therapy between July 2010 and March 2018 in Sweden and a population-based sex- and age-matched control group (control:case ratio 5:1), with linked data from the Swedish National Patient Registry and the Prescribed Drug Registry (DISCOVERY study cohort).
Patients with DS (n = 64) had a higher apnea-hypopnea index (51.7 ± 30.3 vs 36.8 ± 29.1 events/h, < .001), Epworth Sleepiness Scale score (13.7 ± 5.9 vs 11.0 ± 4.9, = .001), rate of previous surgery of tonsils and/or adenoids (21.9% vs 8.2%, = .001), and more thyroid replacement hormone therapy (45.3% vs 7.8%, < .001), but lower use of cardiovascular drugs (7.8% vs 22.3%, = .003) compared with controls. At follow-up after 1.3 ± 0.9 years, there were no differences in nocturnal CPAP usage time (5.6 ± 2.4 vs 5.5 ± 2.0 hours, = .77), CPAP adherence ≥ 4 hours/night (62% vs 65%, = .93), or improvement in Epworth Sleepiness Scale score (-5.4 ± 6.8 vs -5.0 ± 2.0, = .84) between DS and non-DS patients.
OSA severity was substantially higher in patients with DS despite an increased rate of tonsil surgery. Treatment outcomes in terms of adherence and improved daytime sleepiness were comparable between groups, underlining the importance of both OSA diagnosis and treatment in patients with DS.
Svensson M, Ekström M, Sundh J, Ljunggren M, Grote L, Palm A. Adherence to CPAP therapy in Down syndrome: the population-based DISCOVERY study. . 2023;19(3):453-458.
唐氏综合征（DS）患者患阻塞性睡眠呼吸暂停（OSA）并需要持续气道正压通气（CPAP）的风险增加，但关于该人群的治疗和结局的数据很少。我们旨在比较 OSA 合并和不合并 DS 的 CPAP 治疗患者的患者特征和结局。
这是一项基于人群的纵向研究，研究对象为 2010 年 7 月至 2018 年 3 月期间在瑞典开始 CPAP 治疗的患者，并与瑞典国家患者登记处和处方药物登记处（DISCOVERY 研究队列）的人口统计学匹配的对照组（对照组：病例比为 5:1）进行了匹配。
DS 患者（n=64）的呼吸暂停低通气指数（51.7±30.3 比 36.8±29.1 事件/小时，<0.001）、Epworth 睡眠量表评分（13.7±5.9 比 11.0±4.9，<0.001）、扁桃体和/或腺样体切除术史发生率（21.9%比 8.2%，<0.001）和更多甲状腺替代激素治疗（45.3%比 7.8%，<0.001）更高，但心血管药物使用率（7.8%比 22.3%，<0.001）更低。在 1.3±0.9 年的随访中，DS 患者和非 DS 患者之间的夜间 CPAP 使用时间（5.6±2.4 比 5.5±2.0 小时，=0.77）、CPAP 依从性≥4 小时/夜（62%比 65%，=0.93）或 Epworth 睡眠量表评分改善（-5.4±6.8 比-5.0±2.0，=0.84）均无差异。
尽管扁桃体切除术的发生率增加，但 DS 患者的 OSA 严重程度明显更高。在依从性和白天嗜睡改善方面，两组的治疗结局相当，这强调了对 DS 患者进行 OSA 诊断和治疗的重要性。
Svensson M, Ekström M, Sundh J, Ljunggren M, Grote L, Palm A. 在唐氏综合征中 CPAP 治疗的依从性：基于人群的 DISCOVERY 研究。. 2023;19(3):453-458.
