폐쇄성 수면무호흡증 환자에서 양압기 치료에 대한 1년 이상 순응군과 비순응군의 비교
Comparison of Adherent and Non-Adherent Groups to Positive Airway Pressure Therapy for More Than One Year in Patients with Obstructive Sleep Apnea
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Background and Objectives: The use of positive airway pressure (PAP) is the treatment of choice for patients with obstructive sleep apnea (OSA), however, poor adherence remains a major cause of treatment failure. The objective of this retrospective study was to compare the differences between adherent and non-adherent groups to auto-titration PAP (APAP) therapy for more than one year in patients with OSA. Materials and Methods: Total 111 patients with OSA who had completed the 3 months compliance assessment for Korean national health insurance coverage were enrolled. They were allocated to adherent (using APAP for more than 12 months) or non-adherent group. Patients’ medical records, polysomnographic data, and APAP use data at the time of passing adaptation period were analyzed, and the differences between the two groups were compared. Results: The number of patients in the adherent group was 66 (59.5%), and the non-adherent group was 45 (40.5%). There were no significant between-group differences in body mass index, Epworth sleepiness scale, apnea-hypopnea index (AHI), and APAP device data by binary logistic regression analysis. However, patients with severe OSA (AHI≥30) were more likely to be compliant with PAP therapy than patients with mild to moderate OSA (odds ratio 3.433, 95% confidence interval 1.329–8.870, p=0.011). Conclusion: The percentage of patients who used APAP devices for more than 12 months was 59.5% in this study. Disease severity (AHI≥30) seems to be a predictor for APAP compliance for more than one year in patients with OSA.
Abstract
Background and Objectives: The use of positive airway pressure (PAP) is the treatment of choice for patients with obstructive sleep apnea (OSA), however, poor adherence remains a major cause of treatment failure. The objective of this retrospective study was to compare the differences between adherent and non-adherent groups to auto-titration PAP (APAP) therapy for more than one year in patients with OSA. Materials and Methods: Total 111 patients with OSA who had completed the 3 months compliance assessment for Korean national health insurance coverage were enrolled. They were allocated to adherent (using APAP for more than 12 months) or non-adherent group. Patients’ medical records, polysomnographic data, and APAP use data at the time of passing adaptation period were analyzed, and the differences between the two groups were compared. Results: The number of patients in the adherent group was 66 (59.5%), and the non-adherent group was 45 (40.5%). There were no significant between-group differences in body mass index, Epworth sleepiness scale, apnea-hypopnea index (AHI), and APAP device data by binary logistic regression analysis. However, patients with severe OSA (AHI≥30) were more likely to be compliant with PAP therapy than patients with mild to moderate OSA (odds ratio 3.433, 95% confidence interval 1.329–8.870, p=0.011). Conclusion: The percentage of patients who used APAP devices for more than 12 months was 59.5% in this study. Disease severity (AHI≥30) seems to be a predictor for APAP compliance for more than one year in patients with OSA.
참고문헌 (25)
- 최우리, "The Impact of National Health Insurance Coverage on Compliance With Positive Airway Pressure Therapy in Patients With Obstructive Sleep Apnea", Clinical and Experimental Otorhinolaryngology, 15(1), pp.100~106 (2022), 대한이비인후과학회[DOI]
- 고태경, "수면다원검사와 양압기 치료의 급여화", 임상이비인후과, 30(1), pp.5~11 (2019), 대한이비인후과학회 부산,울산,경남 지부회[DOI]
- Van Ryswyk E, "Predictors of long-term adherence to continuous positive airway pressure in patients with obstructive sleep apnea and cardiovascular disease", Sleep, 42(10), pp.zsz152~ (2019)
- Boyacı H, "Positive airway pressure device compliance of the patients with obstructive sleep apnea syndrome", Adv Clin Exp Med, 22(6), pp.809~815 (2013)
- Gagnadoux F, "Influence of marital status and employment status on long-term adherence with continuous positive airway pressure in sleep apnea patients", PLOS ONE, 6(8), pp.e22503~ (2011)
- 윤효은, "Improved Adherence to Positive Airway Pressure Treatment after Covering National Health Insurance in Patient with Obstructive Sleep Apnea: A Tertiary Sleep Center Review", Journal of sleep medicine, 18(1), pp.22~28 (2021), 대한수면연구학회[DOI]
- Lettieri CJ, "Impact of group education on continuous positive airway pressure adherence", J Clin Sleep Med, 9(6), pp.537~541 (2013)
- Madbouly EM, "The role of severity of obstructive sleep apnea measured by apnea-hypopnea index in predicting compliance with pressure therapy, a meta-analysis", Am J Ther, 21(4), pp.260~264 (2014)
- McArdle N, "Long-term use of CPAP therapy for sleep apnea", hypopnea syndrome, 1999, pp.159(4), 1108~1114
- Bizieux-Thaminy A, "Long term use of nCPAP therapy in sleep apnoea patients", Rev Mal Respir, 22(6 Pt 1), pp.951~957 (2005)
- Wolkove N, "Long-term compliance with continuous positive airway pressure in patients with obstructive sleep apnea", Can Respir J, 15(7), pp.365~369 (2008)
- Waldhorn RE, "Long-term compliance with nasal continuous positive airway pressure therapy of obstructive sleep apnea", Chest, 97(1), pp.33~38 (1990)
- Walters AS, "Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke", Sleep, 32(5), pp.589~597 (2009)
- Cuellar NG, "The effects of periodic limb movements in sleep(PLMS)on cardiovascular disease", Heart Lung, 42(5), pp.353~360 (2013)
- Wilson DL, "Periodic limb movements in sleep during pregnancy : a common but benign disorder?", Sleep Biol Rhythms, 16(1), pp.11~20 (2018)
- Yang C, "Antidepressants and periodic leg movements of sleep", Biol Psychiatry, 58(6), pp.510~514 (2005)
- Mwenge GB, "Effect of changes in periodic limb movements under CPAP on adherence and long term compliance in obstructive sleep apnea", Acta Clin Belg, 73(3), pp.191~198 (2018)
- Budhiraja R, "Prevalence and correlates of periodic limb movements in OSA and the effect of CPAP therapy", Neurology, 94(17), pp.e1820~e1827 (2020)
- Wohlgemuth WK, "Attempters, adherers, and non-adherers : latent profile analysis of CPAP use with correlates", Sleep Med, 16(3), pp.336~342 (2015)
- Kohler M, "Predictors of long-term compliance with continuous positive airway pressure", Thorax, 65(9), pp.829~832 (2010)
- Genzor S, "Adherence of obstructive sleep apnoea syndrome patients to positive airway pressure therapy -10-year follow-up", Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub (2021)[DOI]
- Ebben MR, "The efficacy of three different mask styles on a PAP titration night", Sleep Med, 13(6), pp.645~649 (2012)
- Ryan S, "Nasal pillows as an alternative interface in patients with obstructive sleep apnoea syndrome initiating continuous positive airway pressure therapy", J Sleep Res, 20(2), pp.367~373 (2011)
- Duarte RLM, "Nasal versus oronasal mask in patients under auto-adjusting continuous positive airway pressure titration : a real-life study", Eur Arch Otorhinolaryngol, 277(12), pp.3507~3512 (2020)
- Rowland S, "Comparing the efficacy, mask leak, patient adherence, and patient preference of three different CPAP interfaces to treat moderate-severe obstructive sleep apnea", J Clin Sleep Med, 14(1), pp.101~108 (2018)
