본문 바로가기
KERD
논문KCI 등재

렘수면 관련 폐쇄성 수면무호흡 환자들에서 기도양압기 치료의 순응도와 효과분석

Compliance and Efficacy of Positive Airway Pressure Therapy In Rapid Eye Movement Sleep Related Obstructive Sleep Apnea Patients

김민우|최명수|진명호
대한이비인후과학회 (Korean Society of Otorhinolaryngology-Head and Neck Surgery)|2024.08|대한이비인후과학회지 두경부외과학 (Korean Journal of Otorhinolaryngology-Head and Neck Surgery)|제67권 제8호|pp. 440-446|DOI 10.3342/kjorl-hns.2023.00885

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

ComplianceContinuous positive airway pressureObstructive sleep apneaRapid eye movement sleep.
주제분류이비인후과학

초록

Background and Objectives The aim of this study was to investigate the compliance andtreatment effects of both rapid eye movement sleep related obstructive sleep apnea (REM_OSA) and non-stage specific OSA (NS_OSA) patients prescribed with positive airway pres-sure (PAP) therapy. Subjects and Method Medical records of 223 patients diagnosed with OSA from July 2021to March 2023 were retrospectively analyzed. Six-month PAP compliance, symptoms question-naires were compared for 60 patients in the REM_OSA group and 163 in the NS_OSA group. Results For patients in mild NS_OSA, mild REM_OSA, moderate NS_OSA, moderate REM_OSA, severe NS_OSA, and severe REM_OSA groups, the compliance of six-month PAP was50.0%, 33.3% ( p=0.467), 69.6%, 58.3% ( p>0.999), 70.7%, and 0% ( p=0.023), respectively. Inthe NS_OSA group, PAP led to significant daytime sleepiness score improvement (7.3±3.4 to5.7 ±3.6, p=0.022). In contrast, the scores for the REM_OSA group changed insignificantly(8.4±4.7 to 6.8±2.9, p=0.332). Conclusion This study revealed that PAP therapy compliance of the REM_OSA group wasnot lower than that of the NS_OSA group, except for the severe subgroup. However, REM_OSAwas found to be less effective in improving daytime sleepiness symptoms than NS_OSA after PAP therapy.

Abstract

Background and Objectives The aim of this study was to investigate the compliance andtreatment effects of both rapid eye movement sleep related obstructive sleep apnea (REM_OSA) and non-stage specific OSA (NS_OSA) patients prescribed with positive airway pres-sure (PAP) therapy. Subjects and Method Medical records of 223 patients diagnosed with OSA from July 2021to March 2023 were retrospectively analyzed. Six-month PAP compliance, symptoms question-naires were compared for 60 patients in the REM_OSA group and 163 in the NS_OSA group. Results For patients in mild NS_OSA, mild REM_OSA, moderate NS_OSA, moderate REM_OSA, severe NS_OSA, and severe REM_OSA groups, the compliance of six-month PAP was50.0%, 33.3% ( p=0.467), 69.6%, 58.3% ( p>0.999), 70.7%, and 0% ( p=0.023), respectively. Inthe NS_OSA group, PAP led to significant daytime sleepiness score improvement (7.3±3.4 to5.7 ±3.6, p=0.022). In contrast, the scores for the REM_OSA group changed insignificantly(8.4±4.7 to 6.8±2.9, p=0.332). Conclusion This study revealed that PAP therapy compliance of the REM_OSA group wasnot lower than that of the NS_OSA group, except for the severe subgroup. However, REM_OSAwas found to be less effective in improving daytime sleepiness symptoms than NS_OSA after PAP therapy.

참고문헌 (22)

  1. Lee YJ, "Updates of diagnosis and treatment of sleep-related breathing disorders-focusing on obstructive sleep apnea", J Korean Neuropsychiatr Assoc, 59(1), pp.20~24 (2020)
  2. Gilman MP, "Continuous positive airway pressure increases heart rate variability in heart failure patients with obstructive sleep apnoea", Clin Sci(Lond), 114(3), pp.243~249 (2008)
  3. Shahar E, "Sleep-disordered breathing and cardiovascular disease : cross-sectional results of the sleep heart health study", Am J Respir Crit Care Med, 163(1), pp.19~25 (2001)
  4. Grace KP, "Identification of the mechanism mediating genioglossus muscle suppression in REM sleep", Am J Respir Crit Care Med, 187(3), pp.311~319 (2013)
  5. Mokhlesi B, ""REM-related"obstructive sleep apnea : an epiphenomenon or a clinically important entity?", Sleep, 35(1), pp.5~7 (2012)
  6. Peppard PE, "The impact of obesity on oxygen desaturation during sleep-disordered breathing", Am J Respir Crit Care Med, 180(8), pp.788~793 (2009)
  7. Kohler M, "CrossTalk proposal : most of the cardiovascular consequences of OSA are due to increased sympathetic activity", J Physiol, 590(12), pp.2813~2815 (2012)
  8. Haba-Rubio J, "Rapid eye movementrelated disordered breathing : clinical and polysomnographic features", Chest, 128(5), pp.3350~3357 (2005)
  9. Conwell W, "Prevalence, clinical features, and CPAP adherence in REMrelated sleep-disordered breathing: a cross-sectional analysis of a large clinical population", Sleep Breath, 16(2), pp.519~526 (2012)
  10. Su CS, "Functional outcomes in patients with REM-related obstructive sleep apnea treated with positive airway pressure therapy", J Clin Sleep Med, 8(3), pp.243~247 (2012)
  11. Almeneessier AS, "Long-term adherence to continuous positive airway pressure in patients with rapid eye movement-only obstructive sleep apnea : a prospective cohort study", J Thorac Dis, 9(10), pp.3755~3765 (2017)
  12. Kribbs NB, "Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea", Am Rev Respir Dis, 147(4), pp.887~895 (1993)
  13. Hoshino T, "Effect of rapid eye movement-related obstructive sleep apnea on adherence to continuous positive airway pressure", J Int Med Res, 46(6), pp.2238~2248 (2018)
  14. Kohler M, "Predictors of longterm compliance with continuous positive airway pressure", Thorax, 65(9), pp.829~832 (2010)
  15. Budhiraja R, "Early CPAP use identifies subsequent adherence to CPAP therapy", Sleep, 30(3), pp.320~324 (2007)
  16. Simon-Tuval T, "Low socioeconomic status is a risk factor for CPAP acceptance among adult OSAS patients requiring treatment", Sleep, 32(4), pp.545~552 (2009)
  17. McArdle N, "Long-term use of CPAP therapy for sleep apnea", hypopnea syndrome, 1999, pp.159(4 Pt 1), 1108~1114
  18. Yetkin O, "CPAP compliance in patients with obstructive sleep apnea syndrome", Sleep Breath, 12(4), pp.365~367 (2008)
  19. Engleman HM, "Effect of CPAP therapy on daytime function in patients with mild sleep apnoea", hypopnoea syndrome, 1997, pp.52(2), 114~119
  20. Wells RD, "Adherence, reports of benefits, and depression among patients treated with continuous positive airway pressure", Psychosom Med, 69(5), pp.449~454 (2007)
  21. Park SI, "Predictors for short-term and long-term automatic PAP compliance", J Clin Sleep Med, 19(1), pp.17~26 (2023)
  22. Alzoubaidi M, "Obstructive sleep apnea during rapid eye movement sleep : clinical relevance and therapeutic implications", Curr Opin Pulm Med, 22(6), pp.545~554 (2016)

관련 논문AI추천

폐쇄성 수면무호흡증 환자에서 양압기 치료에 대한 1년 이상 순응군과 비순응군의 비교금상연, 박진우, 박희준, 신승헌, 예미경, 유재호대한이비인후과학회 부산,울산,경남 지부회 · 임상이비인후과2022 · 제33권 제3호폐쇄성 수면무호흡 환자에서 양압기 치료 후 잔존 주간졸림증상 분석김종관, 최명수대한이비인후과학회 · 대한이비인후과학회지 두경부외과학2025 · 제68권 제7호중증 폐쇄성 수면무호흡증에서 자동형 양압기와 고정형 양압기 치료의 비교 분석김성동, 김화빈, 문수진, 이근익, 조규섭, 조일녕대한이비인후과학회 · 대한이비인후과학회지 두경부외과학2020 · 제63권 제3호폐쇄수면무호흡증환자에서 자동 비강기도양압기 사용 후 지속되는 주간졸림의 예측인자구대림, 주은연, 최수정, 홍승봉대한신경과학회 · 대한신경과학회지2012 · 제30권 제4호Adherence to Positive Airway Pressure therapy as Severity of Adult Obstructive Sleep Apnea유준, 박성민, 서민영, 이민규, 이승훈, 한문수, 황선진대한이비인후과학회 · 대한이비인후과학회지 두경부외과학2022 · 제65권 제3호건강 보험 적용하에 장기적으로 양압기 치료를 했던 폐쇄성 수면무호흡증 환자에서 중단 요인 분석김성동, 김현수, 박지환, 장서윤, 조규섭, 조현주대한이비인후과학회 부산,울산,경남 지부회 · 임상이비인후과2023 · 제34권 제2호

이 간행물의 다른 논문 (6건)

이명과 폐쇄성 수면무호흡박정민, 이전미, 이승재, 최익수pp. 423-430노인의 대사 건강과 청력 장애: 노인코호트 추적 연구서지영, 오윤환, 박범식, 정석송, 김혜준pp. 431-439체질량지수와 후두암 발병률의 연관성홍찬의, 김진국, 조재훈, 주영훈pp. 447-451안면신경 마비로 발현된 두개경화 동반 선상골병증 1예홍태의, 이보련, 허경욱, 김우진pp. 452-456비중격 피판과 대퇴근막을 이용한 의인성 두개저 결손의 내시경적 재건박해찬, 한두희, 김용휘pp. 457-461
원문 보기