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阻塞性睡眠呼吸暂停患者无创通气依从性的多变量研究

A Multivariate Study on the Adherence With Non-invasive Ventilation in People With Obstructive Sleep Apnea.

作者信息

Karagiannis Athanasios, Kafkia Theodora, Tzitiridou Maria, Kourakos Michael

机构信息

Department of Midwifery, University of Western Macedonia, Ptolemaida, Greece.

Department of Nursing, International Hellenic University, Thessaloniki, Greece.

出版信息

Acta Inform Med. 2023;32(1):37-42. doi: 10.5455/aim.2024.32.37-42.

Abstract

BACKGROUND

Obstructive Sleep Apnea (OSA) is a sleep disorder that affects a significant number of people worldwide. While Continuous Positive Airway Pressure (CPAP) devices have been proven to be effective in relieving symptoms, ensuring consistent use of those devices throughout the year can be challenging for a lot of patients.

OBJECTIVE

The present quantitative observational study in non-invasive ventilation for OSA patients explores adherence and attempts to identify independent predicting factors and year-round adherence differences in a large sample of OSA patients from Greece.

METHODS

Data from 1987 OSA patients using Continuous Positive Airway Pressure (CPAP) devices were collected in 2023. Factors evaluated in the study included the Apnea-Hypopnea Index (AHI), mask type, mask leaks and hours of CPAP device usage.

RESULTS

The majority were males (77.2%), aged over 60 years (57.9%). CPAP use varied, with 14.0% in their first year, 44.2% for 2-4 years, and 41.7% for <4 years. Adherence was highest in more than 4 years users (54.9%) and nasal/pillow mask users (59.1%). Seasonal adherence varied, with summer having the most non-adherent patients (32.8%). Multinomial logistic regression showed BMI, mask type and seasonal severity influenced adherence. Full-face masks positively impacted adherence (OR=0.585, p=0.001). Non-adherence was associated with higher mask leaking in spring (OR=3.051, p=0.018) and usage of CPAP for < 4 years (OR=3.855, p=0.001). For 50% and 75% adherence, seasonal mask leaking and usage duration influenced adherence.

CONCLUSION

CPAP device data can provide valuable insights to OSA therapy compliance. Seasonality plays an important role in adherence to the CPAP device use as is the type of mask with relation to air leaking.

摘要

背景

阻塞性睡眠呼吸暂停(OSA)是一种睡眠障碍,全球有大量人群受其影响。虽然持续气道正压通气(CPAP)设备已被证明能有效缓解症状,但确保许多患者全年持续使用这些设备具有挑战性。

目的

本针对OSA患者的无创通气定量观察性研究探讨了依从性,并试图在来自希腊的大量OSA患者样本中识别独立预测因素和全年依从性差异。

方法

2023年收集了1987名使用持续气道正压通气(CPAP)设备的OSA患者的数据。该研究评估的因素包括呼吸暂停低通气指数(AHI)、面罩类型、面罩漏气情况和CPAP设备使用时长。

结果

大多数为男性(77.2%),年龄超过60岁(57.9%)。CPAP的使用情况各不相同,第一年使用的占14.0%,使用2至4年的占44.2%,使用不足4年的占41.7%。使用超过4年的患者(54.9%)和使用鼻罩/枕式面罩的患者(59.1%)依从性最高。季节性依从性有所不同,夏季不依从的患者最多(32.8%)。多项逻辑回归显示,体重指数、面罩类型和季节性严重程度会影响依从性。全面罩对依从性有积极影响(比值比=0.585,p=0.001)。不依从与春季较高的面罩漏气率(比值比=3.051,p=0.018)以及使用CPAP不足4年(比值比=3.855,p=0.001)有关。对于50%和75%的依从率,季节性面罩漏气和使用时长会影响依从性。

结论

CPAP设备数据可为OSA治疗依从性提供有价值的见解。季节性在CPAP设备使用依从性中起着重要作用,面罩类型与漏气情况也是如此。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4397/10997165/b3744c1fd97e/AIM-32-37-g001.jpg

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