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阻塞性睡眠呼吸暂停中与气道正压相关的吞气症:InterfaceVent真实生活研究结果

Positive Airway Pressure-Related Aerophagia in Obstructive Sleep Apnea: Results from the InterfaceVent Real-Life Study.

作者信息

Vidal Celia, Mallet Jean-Pierre, Skinner Sarah, Gilson Raphael, Gaubert Olivier, Prigent Arnaud, Gagnadoux Frédéric, Borel Jean-Christian, Bourdin Arnaud, Molinari Nicolas, Jaffuel Dany

机构信息

Desbrest Institute of Epidemiology and Public Health, National Institute of Health and Medical Research, Montpellier University, 34090 Montpellier, France.

Groupe Adène, 34080 Montpellier, France.

出版信息

J Clin Med. 2025 Sep 11;14(18):6424. doi: 10.3390/jcm14186424.

Abstract

Continuous positive airway pressure (CPAP) effectiveness can be compromised by adverse effects. Despite its potential impact on adherence and sleepiness, aerophagia remains under-recognized and poorly characterized. This ancillary analysis of the InterfaceVent study aimed to identify risk factors for aerophagia in a large real-life cohort of CPAP-treated patients and to assess its association with both CPAP adherence and sleepiness. InterfaceVent was a prospective, real-life, cross-sectional study. Adults treated for at least 3 months with CPAP were included. Patients self-reported mask-related side effects using visual analogue scales. Aerophagia was defined as a dichotomous outcome based on patient-reported symptoms and CPAP non-adherence as mean nightly usage <4 h. Sleepiness was assessed using Epworth Sleepiness Scale (ESS). A total of 1461 patients (median age 67 years (Q1-Q3; 60-74); 27.6% women) were included. Aerophagia was reported by 8.3% of participants. Compared to patients without aerophagia, those affected were younger, more frequently female, and had lower BMI. Patients with aerophagia reported a median ESS score of 7 (4-10) versus 5 (3-8) for patients without aerophagia ( < 0.001). CPAP usage was significantly lower in the aerophagia group (median 6.37 vs. 6.75 h/day; = 0.001), whereas non-adherence, did not significantly differ between groups (10.7% vs. 7.5%; = 0.20). This ancillary analysis of the InterfaceVent study highlights the burden of aerophagia in CPAP-treated patients and identifies modifiable and non-modifiable risk factors. Better recognition and management of this under-reported side effect may improve CPAP adherence and patient comfort. InterfaceVent is registered with ClinicalTrials.gov (NCT03013283). The first registration date is 23 December 2016.

摘要

持续气道正压通气(CPAP)的有效性可能会受到不良反应的影响。尽管气吞症对依从性和嗜睡有潜在影响,但它仍然未得到充分认识,其特征也了解甚少。这项对InterfaceVent研究的辅助分析旨在确定在接受CPAP治疗的大量真实队列患者中气吞症的危险因素,并评估其与CPAP依从性和嗜睡的关系。InterfaceVent是一项前瞻性、真实、横断面研究。纳入了接受CPAP治疗至少3个月的成年人。患者使用视觉模拟量表自我报告与面罩相关的副作用。气吞症根据患者报告的症状定义为二分结局,CPAP不依从定义为平均每晚使用时间<4小时。使用爱泼华嗜睡量表(ESS)评估嗜睡情况。共纳入1461例患者(中位年龄67岁(四分位间距Q1-Q3;60-74岁);27.6%为女性)。8.3%的参与者报告有气吞症。与无气吞症的患者相比,受影响的患者更年轻,女性更常见,且体重指数更低。有气吞症的患者报告的ESS中位评分为7(4-10),而无气吞症的患者为5(3-8)(P<0.001)。气吞症组的CPAP使用时间显著更低(中位时间6.37小时/天对6.75小时/天;P=0.001),而两组间的不依从情况无显著差异(10.7%对7.5%;P=0.20)。对InterfaceVent研究的这项辅助分析突出了气吞症在接受CPAP治疗患者中的负担,并确定了可改变和不可改变的危险因素。更好地认识和管理这种报告不足的副作用可能会提高CPAP的依从性和患者舒适度。InterfaceVent已在ClinicalTrials.gov注册(NCT03013283)。首次注册日期为2016年12月23日。

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