用于预测阻塞性睡眠呼吸暂停患者不坚持持续气道正压疗法的提名图的开发与验证。

IF 3 2区医学 Q2 CLINICAL NEUROLOGY Nature and Science of Sleep Pub Date : 2024-10-28 eCollection Date: 2024-01-01 DOI:10.2147/NSS.S488208

Xingjia Hu, Yating You, Hui Wang, Yiqing Zheng, Ying Wang

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引用次数: 0

摘要

背景：持续气道正压（CPAP）是治疗阻塞性睡眠呼吸暂停（OSA）的有效方法，但其长期疗效因患者依从性差而受到限制。本研究旨在开发并验证一种预测 OSA 患者不坚持使用 CPAP 的提名图：这是一项回顾性研究的二次分析。方法：这是一项回顾性研究的二次分析，对 695 名丹麦 OSA 患者进行了为期 3 年的 CPAP 治疗后随访。使用多变量 Cox 回归评估了独立相关因素，然后构建了预测 CPAP 使用依从性的提名图。使用接收器操作特征曲线（ROC）、校准曲线和决策曲线分析（DCA）对提名图的辨别能力进行了评估：结果：肺部疾病、氧饱和度指数 (ODI)、埃普沃斯嗜睡评分 (ESS) 和 OSA 的严重程度被确定为预测因素并纳入提名图。在训练数据集（0.73，95% CI：0.69-0.78）和验证数据集（0.72，95% CI：0.66-0.79）中，提名图显示了良好的区分度和一致性指数。ROC曲线、校准曲线和DCA表明该提名图具有良好的临床实用性：本研究为预测 OSA 患者的 CPAP 不依从性提供了一个有效的提名图。

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Development and Validation of a Nomogram for Predicting Non-Adherence to Continuous Positive Airway Pressure Therapy in Patients with Obstructive Sleep Apnea.

Background: Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea (OSA), but its long-term efficacy is limited by poor patient adherence. This study aimed to develop and validate a predictive nomogram for CPAP non-adherence in patients with OSA.

Methods: This is a secondary analysis of a retrospective study. A cohort of 695 Danish patients with OSA were followed for 3 years after initiating CPAP therapy. Independently associated factors were evaluated using multivariate Cox regression, and then nomogram predicting adherence to CPAP use were constructed. The discrimination of the nomogram was assessed using receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA).

Results: Pulmonary disease, oxygen desaturation index (ODI), Epworth Sleepiness Score (ESS) and severity of OSA were identified as predictors and incorporated into the nomogram. The nomogram demonstrated good discrimination with concordance index in training dataset (0.73, 95% CI: 0.69-0.78) and validation dataset (0.72, 95% CI: 0.66-0.79). ROC curve, calibration curve, and DCA indicated the nomogram had good clinical utility.

Conclusion: This study provided an effective nomogram for predicting CPAP non-adherence in OSA patients.

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.