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持续气道正压通气依从性的预测因素以及韩国阻塞性睡眠呼吸暂停成年依从者与不依从者之间临床因素和多导睡眠图结果的比较

Predictors of Continuous Positive Airway Pressure Adherence and Comparison of Clinical Factors and Polysomnography Findings Between Compliant and Non-Compliant Korean Adults With Obstructive Sleep Apnea.

作者信息

Cho Seo-Eun, Jung Joo Hyun, Kang Jae Myeong, Cho Min Young, Lee Yea Seol, Kang Seung-Gul, Kim Seon Tae

机构信息

Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.

Department of Otolaryngology, Head and Neck Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.

出版信息

Psychiatry Investig. 2024 Feb;21(2):200-207. doi: 10.30773/pi.2023.0175. Epub 2024 Feb 22.

Abstract

OBJECTIVE

Continuous positive airway pressure (CPAP) is the preferred treatment for obstructive sleep apnea (OSA). However, compliance with CPAP therapy varies among studies, and studies on its predictors are insufficient in Korea. This study aimed to identify factors that predict compliance with CPAP therapy in patients with OSA.

METHODS

We retrospectively reviewed medical records, polysomnography (PSG) records, and self-report questionnaires of patients w ith OSA. Criteria for compliance was the use of CPAP devices for ≥4 h per night for ≥70% of the consecutive 30 nights (i.e., 21 days) during the first 3 months of treatment initiation. The patients were classified into two groups: compliant and non-compliant. Logistic regression analyses were performed to identify the clinical factors and PSG parameters associated with CPAP compliance.

RESULTS

Of the 188 participants, 80 were classified into the compliant group and 108 into the non-compliant group. The ratios of stage N1 (p=0.011) and health insurance coverage (p=0.007) were significantly associated with compliance with CPAP, with an explanatory power of 18.6% (R2=0.186, p<0.001).

CONCLUSION

Stage N1 ratio and health insurance coverage were significant predictors of CPAP compliance. It is necessary to confirm whether the relationship between a high stage N1 ratio and compliance can be reproduced in a larger sample and in individuals from other countries.

摘要

目的

持续气道正压通气(CPAP)是阻塞性睡眠呼吸暂停(OSA)的首选治疗方法。然而,不同研究中CPAP治疗的依从性有所不同,且韩国关于其预测因素的研究不足。本研究旨在确定OSA患者中预测CPAP治疗依从性的因素。

方法

我们回顾性分析了OSA患者的病历、多导睡眠图(PSG)记录和自我报告问卷。依从性标准为在开始治疗的前3个月内,连续30晚(即21天)中每晚使用CPAP设备≥4小时,且使用天数≥70%。患者被分为两组:依从组和不依从组。进行逻辑回归分析以确定与CPAP依从性相关的临床因素和PSG参数。

结果

188名参与者中,80名被分类为依从组,108名被分类为不依从组。N1期比例(p = 0.011)和医疗保险覆盖情况(p = 0.007)与CPAP依从性显著相关,解释力为18.6%(R2 = 0.186,p < 0.001)。

结论

N1期比例和医疗保险覆盖情况是CPAP依从性的重要预测因素。有必要确认在更大样本以及其他国家的个体中,高N1期比例与依从性之间的关系是否能够重现。

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