Rauscher H, Formanek D, Zwick H
Pulmonary Department, Krankenhaus Lainz, Vienna, Austria.
Chest. 1995 Jan;107(1):58-61. doi: 10.1378/chest.107.1.58.
The feasibility of nasal continuous positive airway pressure (CPAP) for heavy snoring associated with daytime sleepiness was studied in 118 consecutive patients with an apnea hypopnea index below 5. Fifty-nine of them reported daytime sleepiness in a questionnaire and were offered treatment with nasal CPAP. Whereas 48 patients refused it, the remaining 11 (19%) accepted nasal CPAP for home therapy. Acceptors and refusers did not differ in sleep structure, but acceptors had slightly more sleep-disordered breathing events per hour of sleep than refusers. The pressure needed to abolish snoring in these 11 patients was 7.3 +/- 1.6 cm H2O. Six months after prescription, the built-in time counters of the patients' devices were read. By dividing the hours of operation by the days since initiation of treatment, we found a mean daily use time of only 2.8 +/- 1.5 h. Nevertheless, eight patients (73%) reported that their sleepiness had improved with therapy. We conclude that only a minority of nonapneic snorers accept treatment with nasal CPAP on a long-term basis and that this subgroup is not predictable from polysomnography.
对118例呼吸暂停低通气指数低于5的连续性鼾症且伴有日间嗜睡的患者,研究了鼻持续气道正压通气(CPAP)的可行性。其中59例患者在问卷调查中报告有日间嗜睡,并接受了鼻CPAP治疗。48例患者拒绝治疗,其余11例(19%)接受了鼻CPAP家庭治疗。接受治疗者和拒绝治疗者在睡眠结构上无差异,但接受治疗者每小时睡眠中睡眠呼吸紊乱事件略多于拒绝治疗者。这11例患者消除打鼾所需的压力为7.3±1.6 cm H2O。处方6个月后,读取患者设备的内置时间计数器。通过将运行小时数除以治疗开始后的天数,我们发现平均每日使用时间仅为2.8±1.5小时。然而,8例患者(73%)报告其嗜睡症状经治疗后有所改善。我们得出结论,只有少数非呼吸暂停性打鼾者长期接受鼻CPAP治疗,且该亚组无法通过多导睡眠图预测。