Edinger J D, Carwile S, Miller P, Hope V, Mayti C
Psychology Service (116b), VA Medical Center, Durham, NC 27705.
Percept Mot Skills. 1994 Jun;78(3 Pt 2):1116-8. doi: 10.2466/pms.1994.78.3c.1116.
38 male patients with obstructive sleep apnea were asked to complete 2 weeks of rating symptoms, physical examination, diagnostic polysomnography, and MMPI testing prior to being placed on nasal continuous positive airway pressure (CPAP) therapy. Six months later, 26 (72.2%) of the 36 subjects available for follow-up showed continued compliance. A regression analysis conducted with those 28 subjects who completed all pretreatment measures showed that continued therapy was predicted by such pretreatment measures as patients' body mass index, ratings of daytime sleepiness and nocturnal sleep quality, and MMPI Depression and Hypochondriasis scale scores (R2 = 0.63). Eventual compliers had a higher Body Mass Index, reported less daytime sleepiness and better nocturnal sleep quality, and scored lower on the MMPI D and Hs scales prior to treatment than did the noncompliers. A linear discriminant function analysis with analog cross-validation showed these five predictors would identify approximately 80% of eventual noncompliers and 97% of those who display compliance. It was concluded that subjective report and personality measures may be useful in predicting long-term use. Additional studies are needed to assess the clinical significance of the noted MMPI scale elevations among sleep apnea patients in general and among those patients who display eventual noncompliance.
38名阻塞性睡眠呼吸暂停男性患者在接受鼻持续气道正压通气（CPAP）治疗前，被要求完成为期2周的症状评分、体格检查、诊断性多导睡眠图及明尼苏达多项人格测验（MMPI）。6个月后，在可供随访的36名受试者中，26名（72.2%）持续依从治疗。对完成所有预处理措施的28名受试者进行回归分析，结果显示，患者的体重指数、日间嗜睡评分、夜间睡眠质量评分以及MMPI抑郁量表和疑病量表得分等预处理指标可预测持续治疗情况（R2 = 0.63）。与未依从者相比，最终依从者在治疗前体重指数更高，日间嗜睡情况更少，夜间睡眠质量更好，且MMPI D量表和Hs量表得分更低。采用模拟交叉验证的线性判别函数分析表明，这五个预测指标可识别出约80%的最终不依从者和97%的依从者。研究得出结论，主观报告和人格测量指标可能有助于预测长期治疗的依从性。需要进一步研究来评估在一般睡眠呼吸暂停患者以及最终不依从的患者中，所观察到的MMPI量表升高的临床意义。
