Treatment with continuous positive airway pressure is not effective in patients with sleep apnea but no daytime sleepiness -: A randomized, controlled trial
Treatment with continuous positive airway pressure is not effective in patients with sleep apnea but no daytime sleepiness -: A randomized, controlled trial
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DOI：
10.7326/0003-4819-134-11-200106050-00007
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发表时间：
2001-06-05
影响因子：
39.2
通讯作者：
Agusti, AGN
中科院分区：
文献类型：
--
作者：
Barbé, F;Mayoralas, LR;Agusti, AGN
背景：睡眠呼吸暂停低通气综合征是由睡眠中呼吸事件(呼吸暂停低通气指数，定义为每小时呼吸暂停和低呼吸发作次数)和白天症状(主要是过度嗜睡)的病理数量来定义的。在睡眠呼吸暂停综合征患者中，持续气道正压(CPAP)治疗可使呼吸暂停低通气指数和日间症状恢复正常。目的：探讨CPAP对无睡眠障碍患者的生活质量、客观嗜睡、认知功能和动脉血压的短期影响。设计：多中心随机、安慰剂对照、平行研究。地点：西班牙6所教学医院。患者：55例呼吸暂停低通气指数大于或等于30的患者，白天无嗜睡(Epworth嗜睡量表评分小于或等于10)。干预：患者被随机分配到接受最佳(n=29)或假(n=25)CPAP的患者，并观察6周。测量：生活质量，客观嗜睡(多次睡眠潜伏期测试评分)，认知功能，结果：干预组和对照组在平均(+/-SE)年龄(54+/-2比52+/-2)、呼吸暂停低通气指数(54+/-3比57+/-4)、Epworth嗜睡量表评分(7.0+/-0.4比7.0+/-0.4)和坚持CPAP治疗(5.0+/-0.4比4.0+/-0.5小时/d)方面相似。其他变量，如生活质量、认知功能和动脉血压，在治疗前两组也是相似的。结论：对于呼吸暂停低通气指数大于或等于30且无主观日间嗜睡的患者，CPAP对患者的生活质量、客观嗜睡、警觉性、注意力、记忆力、信息处理、视觉运动协调和动脉血压无明显影响。因此，CPAP治疗不适用于有病理性呼吸暂停-低呼吸指数的非嗜睡患者。
Background: The sleep apnea-hypopnea syndrome is defined by a pathologic number of respiratory events during sleep (the apnea-hypopnea index, defined as the number of apnea and hypopnea episodes per hour) and daytime symptoms (mostly, excessive sleepiness). In patients with the sleep apnea syndrome, treatment with continuous positive airway pressure (CPAP) normalizes both the apnea-hypopnea index and diurnal symptoms. However, the effect of CPAP in persons with a pathologic apnea-hypopnea index without daytime sleepiness is unclear.Objective: To investigate the short-term effects of CPAP on quality of life, objective sleepiness, cognitive function, and arterial blood pressure in nonsleepy patients with a pathologic apnea-hypopnea index.Design: Multicenter randomized, placebo-controlled, parallel-group study.Setting: Six teaching hospitals in Spain.Patients: 55 patients with an apnea-hypopnea index of 30 or greater who did not have daytime sleepiness (Epworth Sleepiness Scale score less than or equal to 10).Intervention: Patients were randomly assigned to receive optimal (n = 29) or sham (n = 25) CPAP and were observed for 6 weeks.Measurements: Quality of life, objective sleepiness (Multiple Sleep Latency Test score), cognitive function, and arterial blood pressure.Results: The intervention and control groups were similar in terms of mean (+/- SE) age (54 +/- 2 vs. 52 +/- 2 years), apnea-hypopnea index (54 +/- 3 vs. 57 +/- 4), Epworth Sleepiness Scale score (7.0 +/- 0.4 vs. 7.0 +/- 0.4) and adherence to CPAP treatment (5.0 +/- 0.4 vs. 4.0 +/- 0.5 hours/d). Other variables, such as quality of life, cognitive function, and arterial blood pressure, were also similar in both groups before treatment. After 6 weeks of CPAP or sham CPAP, none of these variables changed significantly.Conclusion: In patients with an apnea-hypopnea index of 30 or greater and no subjective daytime sleepiness, CPAP does not modify quality of life, objective sleepiness, vigilance, attention, memory, information processing, visuomotor coordination, or arterial blood pressure. Treatment with CPAP is therefore not indicated in nonsleepy patients with a pathologic apnea-hypopnea index.