Pulmonary and critical care medicine, University of Rochester Medical Center, 601 Elmwood Ave, 14642, Rochester, NY, USA.
Medicine department, University of Massachusetts Chan Medical School, 55 Lake Ave, North Worcester, 01655, Worcester, MA, USA.
BMC Pulm Med. 2023 Sep 1;23(1):320. doi: 10.1186/s12890-023-02612-3.
Studies have shown that a significant percentage of patients with obstructive sleep apnea (OSA) do not tolerate continuous positive airway pressure (CPAP) therapy and long-term use may be as low as 30%. Given the lower levels of symptoms and health-related risks, patients with mild sleep apnea may be at even higher risk for non-adherence to long term CPAP. The purpose of our study was to investigate the prevalence and associations of long-term CPAP adherence in first time users with mild sleep apnea diagnosed by home sleep apnea testing (HSAT).
We identified all the patients who were diagnosed with mild sleep apnea (5 = < AHI < 15) by home sleep apnea testing from 01/2013 to 06/2019 at a large, combined community and hospital-based sleep practice. Only first time CPAP users were included. Compliance was defined as CPAP usage ≥ 4 h per night on ≥ 70% of nights over 30 consecutive days. We defined long term adherence as compliance on the 12th month following CPAP set up. Patient demographics, comorbidities, and CPAP compliance at 1st, 3rd, 6th, 9th and 12th month after therapy initiation were collected. We compared and identified the factors that had significant difference (P < 0.1) between compliant and non-compliant groups at the 12th month.
222 patients were included in the analysis. 57 (25.7%) patients were adherent with long term CPAP treatment. The following factors were associated with a greater likelihood for long-term CPAP adherence: older age, lower body mass index (BMI), presence of a bed partner, non-smoker, presence of Diabetes Mellitus (DM), presence of Heart Failure (CHF), lack of depression, and compliance at 1st, 3rd, 6th and 9th month.
Long term CPAP compliance in mild sleep apnea patients is low. Long term adherence to CPAP can be predicted based on CPAP adherence during the first three months.
研究表明，相当大比例的阻塞性睡眠呼吸暂停（OSA）患者不能耐受持续气道正压通气（CPAP）治疗，长期使用率可能低至 30%。由于症状和与健康相关的风险水平较低，轻度睡眠呼吸暂停患者对长期 CPAP 的依从性甚至更高。我们研究的目的是调查通过家庭睡眠呼吸暂停测试（HSAT）诊断为轻度睡眠呼吸暂停（5 = <AHI <15）的首次使用 CPAP 患者的长期 CPAP 依从性的流行率和相关性。
我们从 2013 年 1 月至 2019 年 6 月在一家大型社区和医院联合睡眠实践中，确定了所有通过家庭睡眠呼吸暂停测试诊断为轻度睡眠呼吸暂停（5 = <AHI <15）的患者。仅纳入首次使用 CPAP 的患者。依从性定义为在 30 天连续至少 70%的夜晚，每晚使用 CPAP 时间≥4 小时。我们将长期依从性定义为在 CPAP 开始后第 12 个月的依从性。收集患者人口统计学、合并症和治疗开始后第 1、3、6、9 和 12 个月的 CPAP 依从性。我们比较并确定了在第 12 个月时，在依从组和不依从组之间有显著差异（P < 0.1）的因素。
共纳入 222 例患者进行分析。57 例（25.7%）患者长期 CPAP 治疗依从性较好。以下因素与长期 CPAP 依从性更高相关：年龄较大、体重指数（BMI）较低、有床伴、不吸烟、患有糖尿病（DM）、患有心力衰竭（CHF）、无抑郁，以及第 1、3、6 和 9 个月的 CPAP 依从性。
轻度睡眠呼吸暂停患者的长期 CPAP 依从性较低。可以根据前三个月的 CPAP 依从性来预测长期 CPAP 的依从性。
