一项真实世界观察性研究评估阻塞性睡眠呼吸暂停患者日间过度嗜睡与患者满意度之间的关系。
A real-world observational study assessing relationships between excessive daytime sleepiness and patient satisfaction in obstructive sleep apnea.
机构信息
University of Arizona, Tucson, AZ, USA.
Jazz Pharmaceuticals, Palo Alto, CA, USA.
出版信息
Sleep Med. 2024 Feb;114:42-48. doi: 10.1016/j.sleep.2023.12.011. Epub 2023 Dec 22.
OBJECTIVES/BACKGROUND: To estimate prevalence and severity of excessive daytime sleepiness among patients with obstructive sleep apnea (OSA) who were prescribed treatment; assess perception and satisfaction of OSA-related care; describe relationships between excessive daytime sleepiness, treatment adherence, and patient satisfaction.
PATIENTS/METHODS: A national population-based cross-sectional sample of US adults with clinician-diagnosed OSA was surveyed in January 2021 via Evidation Health's Achievement App. Patients completed the Epworth Sleepiness Scale, rated satisfaction with healthcare provider and overall OSA care, and reported treatment adherence. Covariates affecting excessive daytime sleepiness (average weekly sleep duration, treatment adherence, sleepiness-inducing medications, age, sex, body mass index, nasal congestion, smoking status, and comorbidities) were adjusted in multivariate regression models.
RESULTS
In 2289 participants (50.3 % women; 44.8 ± 11.1 years), EDS was highly prevalent (42 %), and was experienced by 36 % of patients with high positive airway pressure (PAP) therapy adherence. Each additional hour of nightly PAP use was associated with improved sleepiness (a 0.28-point lower Epworth score; p < 0.001). Excessive daytime sleepiness was associated with lower patient satisfaction with healthcare providers and overall care (OR [95 % CI] 0.62 [0.48-0.80] and 0.50 [0.39-0.64], respectively; p < 0.0001), whereas PAP adherence was associated with higher patient satisfaction (OR [95 % CI] 2.37 [1.64-3.43] and 2.91 [2.03-4.17]; p < 0.0001), after adjusting for confounders.
CONCLUSIONS
In a real-world population-based study of patients with OSA, excessive daytime sleepiness was highly prevalent and associated with poor patient satisfaction ratings. Better patient-centered care among patients with OSA may require interventions aimed at addressing excessive daytime sleepiness and treatment adherence.
目的/背景：评估接受治疗的阻塞性睡眠呼吸暂停（OSA）患者中白天过度嗜睡的患病率和严重程度；评估对 OSA 相关护理的认知和满意度；描述白天过度嗜睡、治疗依从性与患者满意度之间的关系。
患者/方法：2021 年 1 月，通过 Evidation Health 的 Achievement App 对美国具有临床诊断的 OSA 的成年人进行了一项全国性基于人群的横断面样本调查。患者完成了 Epworth 嗜睡量表，对医疗保健提供者和整体 OSA 护理的满意度进行了评分，并报告了治疗依从性。调整了影响白天过度嗜睡的协变量（平均每周睡眠时间、治疗依从性、引起嗜睡的药物、年龄、性别、体重指数、鼻塞、吸烟状况和合并症），并在多变量回归模型中进行了分析。
结果
在 2289 名参与者中（50.3%为女性；44.8±11.1 岁），EDS 患病率很高（42%），并且在高正压通气（PAP）治疗依从性的患者中，有 36%的患者存在 EDS。每晚使用 PAP 时间增加 1 小时与嗜睡程度改善相关（Epworth 评分降低 0.28 分；p<0.001）。白天过度嗜睡与患者对医疗保健提供者和整体护理的满意度降低相关（OR [95%CI]分别为 0.62 [0.48-0.80] 和 0.50 [0.39-0.64]；p<0.0001），而 PAP 依从性与患者满意度升高相关（OR [95%CI]分别为 2.37 [1.64-3.43] 和 2.91 [2.03-4.17]；p<0.0001），在调整混杂因素后。
结论
在一项针对 OSA 患者的真实世界基于人群的研究中，白天过度嗜睡非常普遍，并且与较差的患者满意度评分相关。改善 OSA 患者的以患者为中心的护理可能需要干预措施，以解决白天过度嗜睡和治疗依从性问题。
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