Factors predictive of extensive use of CPAP treatment in obstructive sleep apnoea.

IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY Sleep and Breathing Pub Date : 2024-12-01 Epub Date: 2024-08-20 DOI:10.1007/s11325-024-03146-6
Fatma Doghman, Haitham Ballo, Ulla Anttalainen, Tarja Saaresranta
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Abstract

Aim: In patients with obstructive sleep apnoea (OSA), the benefits of continuous positive airway pressure (CPAP) therapy are increased for every additional hour of daily CPAP usage. However, the data of predictors of extensive usage is scarce, if any. Therefore, we evaluated potential predictors affecting extensive treatment usage.

Methods: In this retrospective study, we compiled an institutional cohort of consecutive patients diagnosed with who started CPAP therapy 1999-2022 and were included in a wireless telemonitoring system in May 2022 (N = 14,394). Patients using CPAP device ≥ 9 h/d were stratified into a younger (< 65 years; N = 124) and an older group (≥ 65 years; N = 131).

Results: We found 255 patients (male 61%) eligible for our study, with a median age of 65 (interquartile range, IQR 55-73) years, and mean body mass index (BMI) of 36 ± 6.9 kg/m2. Median CPAP use was 10 h/d (IQR 10-11). BMI and depressive symptoms (DEPS) in the younger group were higher than in the older group (37.9 ± 7 vs. 34.6 ± 6.4 kg/m2, p < 0.001 and 11 (IQR 5-20) vs. 7 (IQR 5-14), p = 0.01, respectively). During follow-up, the BMI of the younger group increased (39.9 ± 12.5 kg/m2 vs. 37.9 ± 7 kg/m2, p = 0.009). DEPS values decreased in the younger group and became comparable between the groups. In multivariate models, the baseline BMI independently predicted extensive CPAP use among the younger age group, and the mask leak among the older group.

Conclusion: BMI at baseline in the younger and mask leak in the older group could be independent predictive factors for extensive use of CPAP.

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阻塞性睡眠呼吸暂停患者广泛使用 CPAP 治疗的预测因素。
目的:对于阻塞性睡眠呼吸暂停(OSA)患者来说,每天多使用一小时 CPAP,持续气道正压(CPAP)疗法的疗效就会增加一小时。然而,有关大量使用的预测因素的数据却很少。因此,我们对影响广泛使用治疗的潜在预测因素进行了评估:在这项回顾性研究中,我们对 1999 年至 2022 年开始接受 CPAP 治疗并在 2022 年 5 月被纳入无线远程监控系统的连续确诊患者(N = 14,394 人)进行了机构队列整理。使用 CPAP 设备时间≥ 9 小时/天的患者被分层为年轻组(结果:我们发现有 255 名患者(男性占 61%)符合研究条件,中位年龄为 65 岁(四分位数间距,IQR 55-73),平均体重指数 (BMI) 为 36 ± 6.9 kg/m2。使用 CPAP 的中位数为 10 小时/天(IQR 10-11)。年轻组的体重指数和抑郁症状(DEPS)高于年长组(37.9 ± 7 vs. 34.6 ± 6.4 kg/m2,P 2 vs. 37.9 ± 7 kg/m2,P = 0.009)。年轻组的 DEPS 值有所下降,各组之间的 DEPS 值相当。在多变量模型中,基线体重指数可独立预测年轻组广泛使用 CPAP 的情况,以及老年组面罩泄漏的情况:结论:年轻组的基线体重指数和年长组的面罩泄漏可能是广泛使用 CPAP 的独立预测因素。
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来源期刊
Sleep and Breathing
Sleep and Breathing 医学-呼吸系统
CiteScore
5.20
自引率
4.00%
发文量
222
审稿时长
3-8 weeks
期刊介绍: The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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