Engleman H M, Martin S E, Douglas N J
Respiratory Medicine Unit, City Hospital, Edinburgh.
Thorax. 1994 Mar;49(3):263-6. doi: 10.1136/thx.49.3.263.
Continuous positive airway pressure (CPAP) therapy is the treatment of choice for the sleep apnoea/hypopnoea syndrome. Compliance with this relatively obtrusive therapy has not been well studied.
Usage of CPAP was investigated in 54 patients with sleep apnoea/hypopnoea syndrome (median 36 (range 7-129) apnoeas + hypopnoeas/hour slept) over the first 1-3 months after starting CPAP therapy. In all cases CPAP usage was monitored by hidden time clocks that indicated for how long the machines were switched on--that is, the CPAP run time. In 32 patients the time at which the CPAP mask pressure was at the therapeutic level of CPAP pressure set for that patient--that is, the mask time--was also monitored. In all patients objective daytime sleepiness was assessed by multiple sleep latency before and after CPAP therapy.
The mean (SE) nightly CPAP run time was 4.7 (0.4) hours. There was no correlation between run time and severity of the sleep apnoea/hypopnoea syndrome as assessed by apnoea + hypopnoea frequency or multiple sleep latency, and no correlation between CPAP usage and improvement in multiple sleep latency. Thirty two patients in whom mask time was recorded had therapeutic CPAP pressures for 89% (3%) of their CPAP run times. Patients who experienced side effects from CPAP used their CPAP machines significantly less than those who did not.
Patients with sleep apnoea/hypopnoea syndrome used CPAP for less than five hours/night on average with no correlation between severity of sleep apnoea/hypopnoea syndrome and CPAP usage. Patients who complained of side effects used their CPAP therapy less. It is recommended that, as a minimum, CPAP run time should be regularly recorded in all patients receiving CPAP therapy.
持续气道正压通气（CPAP）疗法是治疗睡眠呼吸暂停/低通气综合征的首选方法。对于这种相对有侵入性的疗法，其依从性尚未得到充分研究。
在54例睡眠呼吸暂停/低通气综合征患者（每小时睡眠时间中呼吸暂停 + 低通气的中位数为36次（范围7 - 129次））开始CPAP治疗后的最初1 - 3个月内，对CPAP的使用情况进行了调查。在所有病例中，CPAP的使用情况通过隐藏的时钟进行监测，该时钟显示机器开启的时长，即CPAP运行时间。在32例患者中，还监测了CPAP面罩压力处于为该患者设定的CPAP治疗压力水平的时间，即面罩时间。在所有患者中，通过CPAP治疗前后的多次睡眠潜伏期评估客观日间嗜睡情况。
每晚CPAP的平均（标准误）运行时间为4.7（0.4）小时。根据呼吸暂停 + 低通气频率或多次睡眠潜伏期评估，运行时间与睡眠呼吸暂停/低通气综合征的严重程度之间无相关性，CPAP的使用与多次睡眠潜伏期的改善之间也无相关性。记录了面罩时间的32例患者，其CPAP运行时间中有89%（3%）处于治疗性CPAP压力水平。经历CPAP副作用的患者使用CPAP机器的时间明显少于未经历副作用的患者。
睡眠呼吸暂停/低通气综合征患者平均每晚使用CPAP的时间少于5小时，睡眠呼吸暂停/低通气综合征的严重程度与CPAP的使用之间无相关性。抱怨有副作用的患者使用CPAP疗法的时间较少。建议在所有接受CPAP治疗的患者中，至少应定期记录CPAP的运行时间。
