Compliance with Positive Airway Pressure Treatment for Obstructive Sleep Apnea

김지희; 권민수; 송형민; 이봉재; 장용주; 정유삼

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자료유형: 학술저널

저자정보: 김지희 권민수 송형민 이봉재 장용주 정유삼

저널정보: 대한이비인후과학회 Clinical and Experimental Otorhinolaryngology Clinical and Experimental Otorhinolaryngology 제2권 제2호

발행연도: 2009.1

수록면: 90 - 96 (7page)

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Objectives. Positive airway pressure (PAP) is considered a standard treatment for moderate-to-severe obstructive sleep apnea (OSA) patients. However, compliance with PAP treatment is suboptimal because of several types of discomfort experienced by patients. This study investigated compliance with PAP therapy, and affecting factors for such compliance, in OSA patients. Methods. We performed a survey on 69 patients who engaged in PAP therapy between December 2006 and November 2007. After diagnostic polysomnography and manual titration, patients trialed PAP using the ResMed instrument and explored autoadjusting PAP (APAP), continuous PAP (CPAP), and flexible PAP (using expiratory pressure relief [EPR]) at least once every week for 1 month. Compliance measures were mean daily use (hr), percentage of days on which PAP was used, and percentage of days on which PAP was used for >4 hr. Data were obtained at night using the software Autoscan version 5.7� of the ResMed Inc. We obtained data on anthropometric (age, BMI, neck circumflex, Epworth sleepiness scale, Pittsburgh Sleep Quality Index, hypertension, alcohol intake), polysomnographic data (severity of apnea-hypopnea index [AHI], proportion of nonsupine sleep time, position dependence of sleep), PAP mode and AHI during PAP use for affecting factors. Results. After 1 month, 41 of the 69 patients (59.4%) were pleased with PAP therapy and purchased instruments. Twentyfour patients (34.7%) used PAP for more than 3 months. The percentage of days on which PAP was used was statistically higher in patients with hypertension than in normotensive patients (P=0.003). There were negative correlations 1) between nonsupine position sleep time and percentage of days on which PAP was used (r=-0.424, P= 0.039), and 2) between the AHI during PAP use and the percentage of days on which PAP was used for >4 hr (r=- 0.443, P=0.030). There were no statistical differences between AHI, BMI, PAP pressure, or other measured parameters, on the one hand, and compliance, on the other. Conclusion. The affecting factors for PAP use were hypertension history, sleep posture (shorter nonsupine sleep time), and lower AHI during PAP use.

#Obstructive sleep apnea #Continuous positive airway pressure #Compliance #Hypertension #Posture

참고문헌 (19)

참고문헌 신청

Aloia MS / 2005 / Treatment adherence and outcomes in flexible vs standard continuous positive airway pressure therapy / Chest 127 (6) : 2085 ~ 2093

Ballard RD / 2007 / Interventions to improve compliance in sleep apnea patients previously non-compliant with continuous positive airway pressure / J Clin Sleep Med 3 (7) :

Campos-Rodriguez F / 2007 / Long-term effect of continuous positive airway pressure on BP in patients with hypertension and sleep apnea / Chest 132 (6) : 1847 ~ 1852

Chobanian AV / 2003 / The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure:the JNC 7 report / JAMA 28

Engleman HM / 2003 / Improving CPAP use by patients with the sleep apnea/hypopnea syndrome / Sleep Med Rev 7 (1) : 81 ~ 99

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