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폐쇄성수면무호흡증에 대한 지속적 양압치료가 삶의 질에 미치는 영향 : 단일기관 연구

The Effect of Continuous Positive Pressure Therapy for Obstructive Sleep Apnea on Quality of Life : A Single-Institution Study

은헌정|김신일|최말례|신현석|홍세연
대한수면의학회 (Korean Academy of Sleep Medicine)|2020.12|수면정신생리 (Sleep Medicine and Psychophysiology)|제27권 제2호|pp. 56-66|DOI 10.14401/KASMED.2020.27.2.56

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참고문헌

키워드

삶의 질Quality of Life성별 차이Continuous Positive Airway PressureSex difference폐쇄성수면무호흡증지속적 양압Obstructive Sleep Apnea
주제분류정신과학

초록

목 적：본 연구에서는 OSA환자의 임상적 특징과 CPAP 사용 전·후의 삶의 질 정도를 비교하여 CPAP 사용에 따른삶의 질의 개선 정도를 알아보고자 하였다. 방 법：진료기록부를 통한 나이, 성별, 신장, 체중, 체질량지수, 앱워스 주간졸림척도, 수정된 말람파티척도, 한국판 몬트리올 인지평가, 피츠버그 수면의 질 지수를 조사하여 분석하였다. CPAP 사용에 따른 삶의 질의 개선정도를알아보기 위해 연구대상자에게 전화 연락을 취하여 CPAP 사용 전·후의 삶의 질에 대해 시각형 아날로그 척도(VAS) 를 이용하여 조사하였다. 결 과：신장(Z = -4.525, p ＜ 0.001), 체중(Z = -2.844, p ＜ 0.05), 수면의 질(Z = -2.671, p ＜ 0.05)과 각성 지수(Z = -2.105, p ＜ 0.05)에서 통계학적으로 남·녀 간에 차이(p ＜ 0.05)가 있으며 나머지 변수에서는 차이가 없음이 확인되었다. 교차분석에서 χ2 = 7.724, p = 0.024로 p ＜ 0.05보다 작으므로 OSA의 수준별 심각도와 성별 간에 차이가 있음이 확인이 되었다. PreCPAP QOL, PostCPAP QOL, CPAPUse Months, CPAP4Hr/d (%)의 OSA의 수준별 심각도에 따른크기에는 통계적으로 유의미한 순서가 존재하지 않는 것으로 확인되었다(p ＞ 0.05). CPAP 사용 전 AHI와 사용 후AHI의 차이가 36.48 ± 21.54 (t = 11.609, p ＜ 0.001)이었고, CPAP 사용 전 QOL과 사용 후 QOL의 차이가 -25.43 ± 22.06 (t = -7.901, p ＜ 0.001)이었으며 통계적으로 의미 있는 차이(p ＜ 0.001)를 보였다. 결 론：OSA환자 중 남녀간 임상적으로 신장(HT), 체중(BW), 수면의 질(PSQI), 각성지수(AI), OSA의 수준별 심각도에서 남녀 간의 차이가 있었다. 그러나 CPAP전·후에삶의 질은 남녀간 차이가 없었다. 또한 OSA환자에서CPAP 사용 후 삶의 질이 개선되었음을 확인하였다.

Abstract

Objectives: In this study, the clinical characteristics of OSA patients and the quality of life before and after CPAP use were compared to determine the degree of improvement in quality of life according to CPAP use. Methods: Age, sex, height, weight, body mass index, Epworth Sleepiness Scale, Modified Mallampatti Score, Montreal Cognitive Assessment-Korean, and Pittsburgh Sleep Quality Index were compared between men and women through medical records. To understand the degree of improvement in quality of life resulting from use of CPAP, a personal telephone call was made to compare the VAS scores for quality of life before and after CPAP use. Results: In height (HT) (Z = -4.525, p < 0.001), weight (BW) (Z = -2.844, p < 0.05), sleep quality (PSQI) (Z = -2.671, p < 0.05), and arousal index (AI) (Z = -2.105, p < 0.05), there was a difference between men and women (p < 0.05). There was no difference in the remaining variables. Cross-analysis (Chi-square test) confirmed a difference between severity and sex of OSA. It has been found that there is no statistically significant order in size according to level-specific severity of OSA for PreCPAP QOL, PostCPAP QOL, CPAPUse Months, and CPAP4Hr/d (%) (p > 0.05). The difference between AHI before and after CPAP was 36.48 ± 21.54 (t = 11.609, p < 0.001) and the difference between QOL before and after CPAP was –25.43 ± 22.06 (t = -7.901, p < 0.001), both of which were significant (p < 0.001). Conclusion: Among OSA patients, there were differences in height (HT), weight (BW), sleep quality (PSQI), arousal index (AI), and severity of OSA between men and women, but the quality of life before and after CPAP was different. However, there was no difference between men and women in quality of life before and after CPAP. In addition, quality of life in OSA patients improved after using CPAP

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