PDF(Pubmed)
Abstract：
OBJECTIVE: Positive airway pressure (PAP) compliance is important in treating obstructive sleep apnea. Previous studies have suggested that patients with economic burdens, discomfort using machines, and insufficient education have difficulty tolerating PAP machines. This study explored the factors affecting short-term adherence to PAP in a veterans medical center.
METHODS: The medical records of patients who underwent polysomnography at the Veterans Health Service Medical Center, Seoul, Republic of Korea, between July 2018 and January 2021 were reviewed retrospectively. Patients with an apnea-hypopnea index (AHI) ≥15 were included (n=579). PAP adherence was defined as continuous use for ≥21 days for ≥4 hours daily for 30 consecutive days for 90 days from the date of PAP prescription.
RESULTS: The PAP-adherent group (n=265, age 66.16±11.28 years) was younger and had more years of education, higher body mass indices, and lower scores in the Insomnia Severity Index and Beck Depression Inventory-II (BDI-II) than those of the PAP-nonadherent group (n=314, age 68.93±10.91 years). Patients who tolerated PAP had a higher AHI, longer duration of oxygen desaturation (less than 90%), and less dream enactment behavior (DEB) than that in those who did not. After adjusting for age, years of education, BDI-II, duration of oxygen desaturation, and presence of DEB, there were more patients with National Health Insurance (NHI) in the PAP-adherent group than in the PAP-nonadherent group (p<0.001).
CONCLUSIONS: We showed that patients with NHI recorded significantly higher adherence compared to that in patients without NHI, among other factors.
METHODS: The medical records of patients who underwent polysomnography at the Veterans Health Service Medical Center, Seoul, Republic of Korea, between July 2018 and January 2021 were reviewed retrospectively. Patients with an apnea-hypopnea index (AHI) ≥15 were included (n=579). PAP adherence was defined as continuous use for ≥21 days for ≥4 hours daily for 30 consecutive days for 90 days from the date of PAP prescription.
RESULTS: The PAP-adherent group (n=265, age 66.16±11.28 years) was younger and had more years of education, higher body mass indices, and lower scores in the Insomnia Severity Index and Beck Depression Inventory-II (BDI-II) than those of the PAP-nonadherent group (n=314, age 68.93±10.91 years). Patients who tolerated PAP had a higher AHI, longer duration of oxygen desaturation (less than 90%), and less dream enactment behavior (DEB) than that in those who did not. After adjusting for age, years of education, BDI-II, duration of oxygen desaturation, and presence of DEB, there were more patients with National Health Insurance (NHI) in the PAP-adherent group than in the PAP-nonadherent group (p<0.001).
CONCLUSIONS: We showed that patients with NHI recorded significantly higher adherence compared to that in patients without NHI, among other factors.
摘要：
目的：气道正压通气（PAP）依从性在治疗阻塞性睡眠呼吸暂停中很重要。以前的研究表明，有经济负担的患者，使用机器的不适，教育不足很难容忍PAP机器。这项研究探讨了影响退伍军人医疗中心短期坚持PAP的因素。
方法：在退伍军人健康服务医疗中心接受多导睡眠监测的患者的医疗记录，首尔,大韩民国,在2018年7月至2021年1月期间进行了回顾性审查.包括呼吸暂停低通气指数（AHI）≥15的患者（n=579）。PAP依从性定义为自PAP处方之日起连续使用≥21天，每天≥4小时，连续30天，共90天。
结果：坚持PAP组（n=265，年龄66.16±11.28岁）更年轻，受教育年限更长，较高的体重指数，失眠严重程度指数和贝克抑郁量表II（BDI-II）的得分低于PAP非粘附组（n=314，年龄68.93±10.91岁）。耐受PAP的患者有较高的AHI，更长的氧气去饱和持续时间（小于90％），与没有梦想的人相比，梦想制定行为（DEB）要少。在调整了年龄之后,多年的教育，BDI-II,氧饱和度的持续时间，还有DEB的存在,PAP粘附组的国民健康保险(NHI)患者多于PAP非粘附组(p<0.001).
结论：我们表明，与无NHI的患者相比，有NHI的患者记录的依从性明显更高，在其他因素中。
方法：在退伍军人健康服务医疗中心接受多导睡眠监测的患者的医疗记录，首尔,大韩民国,在2018年7月至2021年1月期间进行了回顾性审查.包括呼吸暂停低通气指数（AHI）≥15的患者（n=579）。PAP依从性定义为自PAP处方之日起连续使用≥21天，每天≥4小时，连续30天，共90天。
结果：坚持PAP组（n=265，年龄66.16±11.28岁）更年轻，受教育年限更长，较高的体重指数，失眠严重程度指数和贝克抑郁量表II（BDI-II）的得分低于PAP非粘附组（n=314，年龄68.93±10.91岁）。耐受PAP的患者有较高的AHI，更长的氧气去饱和持续时间（小于90％），与没有梦想的人相比，梦想制定行为（DEB）要少。在调整了年龄之后,多年的教育，BDI-II,氧饱和度的持续时间，还有DEB的存在,PAP粘附组的国民健康保险(NHI)患者多于PAP非粘附组(p<0.001).
结论：我们表明，与无NHI的患者相比，有NHI的患者记录的依从性明显更高，在其他因素中。
