Engleman H M, Asgari-Jirhandeh N, McLeod A L, Ramsay C F, Deary I J, Douglas N J
Department of Respiratory Medicine, University of Edinburgh, United Kingdom.
Chest. 1996 Jun;109(6):1470-6. doi: 10.1378/chest.109.6.1470.
The benefits of continuous positive airway pressure (CPAP) therapy in patients with the sleep apnea/hypopnea syndrome (SAHS) are poorly documented and patients use CPAP less than physicians recommend. To establish patients' perceptions of benefit from CPAP and to identify determinants of CPAP use, 204 CPAP users completed a questionnaire relating to use of CPAP therapy, sleepiness, and road traffic incident rate before and after CPAP, perceived change in daytime function and nocturnal symptoms with treatment, and problems with CPAP. Variables from these domains of interest were examined, reduced through principal components analysis and correlated to assess associations between these and polysomnographic measures of illness severity. Self-reported CPAP use averaged 5.8 +/- SD 2 h a night. Subjective sleepiness rated by the Epworth sleepiness scale and road traffic incident rate were significantly reduced by CPAP (p<0.0001). A broad range of function and symptom items were highly significantly improved with CPAP (p<0.0001), corroborating the cost to community and industry from SAHS and the preventive value of CPAP. Road traffic incident rate before treatment was correlated with pre-CPAP sleepiness and SAHS severity. Subjective CPAP use correlated with sleepiness before treatment but not with SAHS severity. CPAP mask problems and side effects were not associated with reduced CPAP use, but "nuisance" complaints of awakenings, noise, and sore eyes from CPAP correlated negatively with reported use. Greater reported CPAP use was associated with better resolution of sleepiness and greater improvement in daytime function and nocturnal symptoms.
持续气道正压通气（CPAP）治疗对睡眠呼吸暂停/低通气综合征（SAHS）患者的益处鲜有文献记载，而且患者使用CPAP的情况低于医生的建议。为了了解患者对CPAP治疗益处的看法并确定CPAP使用的决定因素，204名CPAP使用者完成了一份问卷，内容涉及CPAP治疗的使用情况、嗜睡程度、CPAP治疗前后的道路交通事件发生率、治疗后白天功能和夜间症状的感知变化以及CPAP相关问题。对这些感兴趣领域的变量进行了检查，通过主成分分析进行简化，并进行相关性分析以评估这些变量与疾病严重程度的多导睡眠图测量之间的关联。自我报告的CPAP使用平均每晚5.8±标准差2小时。CPAP显著降低了依匹沃斯嗜睡量表评定的主观嗜睡程度和道路交通事件发生率（p<0.0001）。CPAP显著改善了广泛的功能和症状项目（p<0.0001），证实了SAHS给社区和行业带来的代价以及CPAP的预防价值。治疗前的道路交通事件发生率与CPAP治疗前的嗜睡程度和SAHS严重程度相关。主观CPAP使用情况与治疗前的嗜睡程度相关，但与SAHS严重程度无关。CPAP面罩问题和副作用与CPAP使用减少无关，但因CPAP导致的觉醒、噪音和眼睛疼痛等“困扰”性投诉与报告的使用情况呈负相关。报告的CPAP使用量增加与嗜睡症状的更好缓解以及白天功能和夜间症状的更大改善相关。
