唐氏综合征患者对气道正压通气治疗的依从性：评估基于云的监测数据。

Adherence to positive airway pressure therapy in patients with Down syndrome: assessing cloud-based monitoring data.

作者信息

Bhattacharjee Rakesh, Warner Megan, Nokes Brandon, Landeo Gutierrez Jeremy S, Chen Zihan, Amin Milan D, Malhotra Atul

机构信息

Department of Pediatrics, University of California San Diego, San Diego, California.

Department of Pediatrics, Rady Children's Hospital, San Diego, California.

出版信息

J Clin Sleep Med. 2025 Apr 1;21(4):675-681. doi: 10.5664/jcsm.11520.

DOI:10.5664/jcsm.11520

PMID:39745477

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11965102/

Abstract

STUDY OBJECTIVES

Obstructive sleep apnea is common in Down syndrome (DS) with many patients prescribed positive airway pressure (PAP) therapy. This study evaluates PAP adherence and identifies factors influencing adherence.

METHODS

Retrospective analysis of electronic health records and cloud-based PAP therapy data from patients with DS at Rady Children's Hospital, San Diego, CA. Cloud data were evaluated cross-sectionally at 30- and 90-night post-clinic visit and longitudinally in patients with ≥ 2 90-night data downloads. Outcomes included adherence (percentage of nights with ≥ 4 hours of use) and usage (percentage of nights with any PAP usage). The impact of demographic and PAP therapy factors (eg, mask leak) on these outcomes was also assessed.

RESULTS

Forty-seven patients with DS with cloud-based PAP therapy data over a 90-night period and 46 over a 30-night period were analyzed. The mean age was 17.7 ± 4.6 years (21 females). Median adherence was significantly higher at 30 nights (56.7%, interquartile range: 0.0, 90.8%) than at 90 nights (34.4%, interquartile range: 0.0, 86.7%) ( < .05). Median usage did not differ between the 30-night and 90-night periods. Demographic characteristics and PAP therapy parameters were not associated with adherence or usage. Among the longitudinal cohort (n = 32), median adherence was 69.7% (interquartile range: 19.2, 90.0%), and median usage was 78.2% (interquartile range: 45.2, 95.7%). Compared to an age- and sex-matched cohort without DS, patients with DS demonstrated higher PAP adherence ( < .05).

CONCLUSIONS

Cross-sectional and longitudinal analyses reveal that many patients with DS successfully adhere to PAP therapy, challenging the misconception that they struggle with adherence and proving they may be as successful, if not more, than non-DS patients.

CITATION

Bhattacharjee R, Warner M, Nokes B, et al. Adherence to positive airway pressure therapy in patients with Down syndrome: assessing cloud-based monitoring data. . 2025;21(4):675-681.

摘要

研究目的

阻塞性睡眠呼吸暂停在唐氏综合征（DS）中很常见，许多患者接受了气道正压通气（PAP）治疗。本研究评估PAP治疗的依从性，并确定影响依从性的因素。

方法

对加利福尼亚州圣地亚哥市拉迪儿童医院DS患者的电子健康记录和基于云的PAP治疗数据进行回顾性分析。对云数据在门诊就诊后30晚和90晚进行横断面评估，并对有≥2次90晚数据下载的患者进行纵向评估。结果包括依从性（每晚使用≥4小时的百分比）和使用率（任何一晚使用PAP的百分比）。还评估了人口统计学和PAP治疗因素（如面罩漏气）对这些结果的影响。

结果

分析了47例在90晚期间有基于云的PAP治疗数据的DS患者和46例在30晚期间有此类数据的患者。平均年龄为17.7±4.6岁（21名女性）。30晚时的中位依从性（56.7%，四分位间距：0.0，90.8%）显著高于90晚时（34.4%，四分位间距：0.0，86.7%）（P<0.05）。30晚和90晚期间的中位使用率没有差异。人口统计学特征和PAP治疗参数与依从性或使用率无关。在纵向队列（n = 32）中，中位依从性为69.7%（四分位间距：19.2，90.0%），中位使用率为78.2%（四分位间距：45.2，95.7%）。与年龄和性别匹配的非DS队列相比，DS患者表现出更高的PAP依从性（P<0.05）。