Krieger J, Kurtz D, Petiau C, Sforza E, Trautmann D
Sleep Disorders Unit, University Hospital, Strasbourg, France.
Sleep. 1996 Nov;19(9 Suppl):S136-43. doi: 10.1093/sleep/19.suppl_9.s136.
A prospective study aimed at objectively evaluating compliance with nasal continuous positive airway pressure (CPAP) treatment was conducted in 728 obstructive sleep apnea [OSA; apnea/hypopnea index (AHI) > 15 events/hour] patients and 98 nonapneic snorers (AHI < or = 15 events/hour). Five-hundred seventy-five OSA patients and 33 nonapneic snorers underwent CPAP therapy and were followed-up for an average of 1,176 +/- 38 days (27 to 4,203 days). Compliance to treatment was measured by the mean rate of use of the CPAP device obtained from a built-in time counter. Acceptance of treatment was measured using Kaplan-Meier's model. The acceptance of CPAP was greater than 90% at 3 years and greater than 85% at 7 years in OSA patients. It was greater than 60% at 3 years in nonapneic snorers. The mean rate of CPAP use was 5.7 +/- 1.8 hours/day in OSA patients and 5.6 +/- 1.4 hours/day in snorers who were still on CPAP on October 1, 1995. It was correlated positively with age, body mass index, and AHI, and it was correlated negatively with daytime partial pressure of oxygen (PaO2), forced expiratory volume in 1 second (FEV1), and vital capacity in the group of OSA patients. This study shows that CPAP therapy is reasonably accepted by OSA patients as well as by nonapneic snorers. Both within and between groups, objective disease severity (as measured by the respiratory event index and daytime and nighttime hypoxemia), rather than patients' symptoms or complaints, seemed to play a role in the quality of compliance to treatment.
一项前瞻性研究对728例阻塞性睡眠呼吸暂停（OSA；呼吸暂停/低通气指数[AHI]＞15次/小时）患者和98例非呼吸暂停性打鼾者（AHI≤15次/小时）进行，旨在客观评估鼻持续气道正压通气（CPAP）治疗的依从性。575例OSA患者和33例非呼吸暂停性打鼾者接受了CPAP治疗，并进行了平均1176±38天（27至4203天）的随访。通过从内置时间计数器获得的CPAP设备平均使用速率来衡量治疗依从性。使用Kaplan-Meier模型来衡量治疗接受度。OSA患者3年时CPAP的接受率大于90%，7年时大于85%。非呼吸暂停性打鼾者3年时大于60%。1995年10月1日仍在使用CPAP的OSA患者中，CPAP的平均使用速率为5.7±1.8小时/天，打鼾者为5.6±1.4小时/天。在OSA患者组中，其与年龄、体重指数和AHI呈正相关，与日间氧分压（PaO2）、第1秒用力呼气容积（FEV1）和肺活量呈负相关。该研究表明，OSA患者以及非呼吸暂停性打鼾者对CPAP治疗的接受程度较为合理。在组内和组间，客观疾病严重程度（通过呼吸事件指数以及日间和夜间低氧血症来衡量），而非患者的症状或主诉，似乎在治疗依从性质量方面发挥了作用。
