Mask side-effects are related to gender in long-term CPAP: results from the InterfaceVent real-life study.

IF 5.8 2区医学 Q1 Medicine Respiratory Research Pub Date : 2024-09-06 DOI:10.1186/s12931-024-02965-1

Celia Vidal, Fanny Bertelli, Jean-Pierre Mallet, Raphael Gilson, Jean-Christian Borel, Frédéric Gagnadoux, Arnaud Bourdin, Nicolas Molinari, Dany Jaffuel

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Abstract

Background: Over the past three decades, our understanding of sleep apnea in women has advanced, revealing disparities in pathophysiology, diagnosis, and treatment compared to men. However, no real-life study to date has explored the relationship between mask-related side effects (MRSEs) and gender in the context of long-term CPAP.

Methods: The InterfaceVent-CPAP study is a prospective real-life cross-sectional study conducted in an apneic adult cohort undergoing at least 3 months of CPAP with unrestricted mask-access (34 different masks, no gender specific mask series). MRSE were assessed by the patient using visual analog scales (VAS). CPAP-non-adherence was defined as a mean CPAP-usage of less than 4 h per day. The primary objective of this ancillary study was to investigate the impact of gender on the prevalence of MRSEs reported by the patient. Secondary analyses assessed the impact of MRSEs on CPAP-usage and CPAP-non-adherence depending on the gender.

Results: A total of 1484 patients treated for a median duration of 4.4 years (IQ_25-75: 2.0-9.7) were included in the cohort, with women accounting for 27.8%. The prevalence of patient-reported mask injury, defined as a VAS score ≥ 5 (p = 0.021), was higher in women than in men (9.6% versus 5.3%). For nasal pillow masks, the median MRSE VAS score for dry mouth was higher in women (p = 0.039). For oronasal masks, the median MRSE VAS score for runny nose was higher in men (p = 0.039). Multivariable regression analyses revealed that, for both women and men, dry mouth was independently and negatively associated with CPAP-usage, and positively associated with CPAP-non-adherence.

Conclusion: In real-life patients treated with long-term CPAP, there are gender differences in patient reported MRSEs. In the context of personalized medicine, these results suggest that the design of future masks should consider these gender differences if masks specifically for women are developed. However, only dry mouth, a side effect not related to mask design, impacts CPAP-usage and non-adherence.

Trial registration: INTERFACEVENT IS REGISTERED WITH CLINICALTRIALS.GOV (NCT03013283).FIRST REGISTRATION DATE IS 2016-12-23.

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长期使用 CPAP 时面罩的副作用与性别有关：InterfaceVent 真实生活研究的结果。

背景：在过去的三十年中，我们对女性睡眠呼吸暂停的认识有了很大的进步，发现了与男性相比，女性在病理生理学、诊断和治疗方面的差异。然而，迄今为止还没有一项真实的研究探讨了在长期使用 CPAP 的情况下，面罩相关副作用（MRSE）与性别之间的关系：InterfaceVent-CPAP 研究是一项前瞻性真实横断面研究，研究对象是接受至少 3 个月不受限制面罩使用（34 种不同面罩，无特定性别面罩系列）CPAP 治疗的呼吸暂停成人。患者使用视觉模拟量表（VAS）对 MRSE 进行评估。不坚持使用 CPAP 的定义是平均每天使用 CPAP 少于 4 小时。这项辅助研究的主要目的是调查性别对患者报告的 MRSE 发生率的影响。辅助分析评估了不同性别的 MRSE 对使用 CPAP 和不坚持使用 CPAP 的影响：共有 1484 名患者被纳入队列，治疗时间中位数为 4.4 年（IQ25-75：2.0-9.7），其中女性占 27.8%。患者报告的面罩损伤（定义为 VAS 评分≥ 5（P = 0.021））发生率女性高于男性（9.6% 对 5.3%）。就鼻枕式口罩而言，女性口干的 MRSE VAS 评分中位数更高（p = 0.039）。对于口鼻面罩，男性流鼻涕的 MRSE VAS 中位数得分更高（p = 0.039）。多变量回归分析表明，对于女性和男性而言，口干与使用 CPAP 存在独立的负相关关系，而与不坚持使用 CPAP 存在正相关关系：结论：在现实生活中，长期使用 CPAP 治疗的患者在报告的 MRSE 方面存在性别差异。在个性化医疗的背景下，这些结果表明，如果开发出专门针对女性的面罩，未来面罩的设计应考虑这些性别差异。不过，只有口干这种与面罩设计无关的副作用会影响 CPAP 的使用和不依从性：interfacevent已在clinicaltrials.gov（nct03013283）注册。首次注册日期为2016-12-23。

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来源期刊

Respiratory Research RESPIRATORY SYSTEM-

CiteScore

9.70

自引率

1.70%

发文量

314

审稿时长

4-8 weeks

期刊介绍： Respiratory Research publishes high-quality clinical and basic research, review and commentary articles on all aspects of respiratory medicine and related diseases. As the leading fully open access journal in the field, Respiratory Research provides an essential resource for pulmonologists, allergists, immunologists and other physicians, researchers, healthcare workers and medical students with worldwide dissemination of articles resulting in high visibility and generating international discussion. Topics of specific interest include asthma, chronic obstructive pulmonary disease, cystic fibrosis, genetics, infectious diseases, interstitial lung diseases, lung development, lung tumors, occupational and environmental factors, pulmonary circulation, pulmonary pharmacology and therapeutics, respiratory immunology, respiratory physiology, and sleep-related respiratory problems.