The association between irregularity in sleep-wake rhythm and CPAP adherence

Aya Honma, Marina Nohara, Sato Honma, Akihiro Homma
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Abstract

This study aims to evaluate the association between sleep-wake rhythm regularity and continuous positive airway pressure (CPAP) adherence. We retrospectively analyzed sleep-wake rhythms with activity monitoring and CPAP adherence among obstructive sleep apnea (OSA) patients newly diagnosed and introduced to CPAP therapy at the Sapporo Hanazono Hospital from January 2018 to June 2022. Among a total of 45 patients, 10 withdrew from CPAP therapy within a year. Nineteen were classified into the good-adherence and 16 into the poor-adherence group. No significant differences were detected among the groups in apnea-hypopnea index (AHI), sleep efficiency, or subjective sleep quality, but a difference was observed in sleep latency, with the CPAP withdrawal group showing higher variability in sleep onset and lower regularity and/or amplitude in circadian behavior activity rhythm than the good-adherence group. Our results suggest that irregularities, particularly in sleep onset, and damped sleep-wake rhythm can be risk factors for CPAP withdrawal.

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睡眠-觉醒节律不规律与坚持使用 CPAP 之间的关系
本研究旨在评估睡眠-觉醒节律规律性与持续气道正压(CPAP)依从性之间的关联。我们回顾性分析了 2018 年 1 月至 2022 年 6 月期间在札幌花园医院新确诊并接受 CPAP 治疗的阻塞性睡眠呼吸暂停(OSA)患者的活动监测睡眠-觉醒节律和 CPAP 依从性。在总共 45 名患者中,有 10 人在一年内退出了 CPAP 治疗。19人被归入依从性良好组,16人被归入依从性不良组。两组患者在呼吸暂停-低通气指数(AHI)、睡眠效率或主观睡眠质量方面没有发现明显差异,但在睡眠潜伏期方面发现了差异,与依从性良好组相比,停用 CPAP 治疗组患者的睡眠开始时间变异性更高,昼夜节律行为活动节律的规律性和/或振幅更低。我们的研究结果表明,睡眠不规律(尤其是睡眠开始不规律)和睡眠-觉醒节律受阻可能是停用 CPAP 的风险因素。
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