Adherence to continuous positive airway pressure therapy: the challenge to effective treatment.
Adherence to continuous positive airway pressure therapy: the challenge to effective treatment.
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DOI：
10.1513/pats.200708-119mg
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发表时间：
2008-02-15
期刊：
影响因子：
--
通讯作者：
Grunstein, Ronald R
中科院分区：
文献类型：
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作者：
Weaver, Terri E;Grunstein, Ronald R
尽管持续气道正压通气（CPAP）在逆转睡眠呼吸暂停的上气道阻塞方面具有很高的疗效，但治疗效果受到处方治疗依从性的限制。当依从性定义为每晚使用超过4小时时，据报道46 - 83%的阻塞性睡眠呼吸暂停患者不依从治疗。有证据表明，使用CPAP超过6小时可减少嗜睡，改善日常功能，并将记忆恢复到正常水平。接受CPAP的决定发生在治疗的最初几天。尽管市场上有许多使用CPAP或机器模式的患者接口策略可以改善CPAP的使用，但很少有数据支持这一点。没有一个单一的因素被一致地确定为预测依从性。患者对症状的感知以及嗜睡和日常功能的改善在确定使用模式方面可能比疾病严重程度的生理方面更重要。新出现的数据表明，各种行为干预可能是有效的，以提高持续气道正压通气的遵守。
Despite the high efficacy of continuous positive airway pressure (CPAP) to reverse upper airway obstruction in sleep apnea, treatment effectiveness is limited by variable adherence to prescribed therapy. When adherence is defined as greater than 4 hours of nightly use, 46 to 83% of patients with obstructive sleep apnea have been reported to be nonadherent to treatment. Evidence suggests that use of CPAP for longer than 6 hours decreases sleepiness, improves daily functioning, and restores memory to normal levels. The decision to embrace CPAP occurs during the first few days of treatment. Although many strategies in patient interface with CPAP or machine modality are marketed to improve CPAP usage, there are few data to support this. No single factor has been consistently identified as predictive of adherence. Patient perception of symptoms and improvement in sleepiness and daily functioning may be more important in determining patterns of use than physiologic aspects of disease severity. Emerging data suggest that various behavioral interventions may be effective in improving CPAP adherence.