Predictors of sleepiness in obstructive sleep apnoea at baseline and after 6 months of continuous positive airway pressure therapy.
Predictors of sleepiness in obstructive sleep apnoea at baseline and after 6 months of continuous positive airway pressure therapy.
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DOI：
10.1183/13993003.00348-2017
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发表时间：
2017-11
期刊：
影响因子：
--
通讯作者：
Quan SF
中科院分区：
文献类型：
--
作者：
Budhiraja R;Kushida CA;Nichols DA;Walsh JK;Simon RD;Gottlieb DJ;Quan SF
我们评估了阻塞性睡眠呼吸暂停（OSA）患者在基线和持续气道正压通气（CPAP）治疗6个月后与主观和客观嗜睡相关的因素。我们分析了来自呼吸暂停正压通气长期疗效研究（APPLES）的数据，这是一项前瞻性6个月多中心随机对照试验，纳入1105例OSA受试者，其中558例随机接受主动CPAP治疗。记录治疗前和治疗6个月后的埃普沃思嗜睡评分（ESS）和平均睡眠潜伏期（MSL）。543名（49.1%）参与者存在过度嗜睡（ESS > 10）。年轻、抑郁和高呼吸暂停低通气指数（AHI）与高ESS评分和低MSL相关。随机分配到CPAP组与6个月时嗜睡的几率较低相关。使用CPAP > 4小时/晚的患者嗜睡发生率显著低于使用CPAP ≤4小时/晚的患者。在CPAP依从性良好的患者中，基线ESS >10的患者持续主观嗜睡的几率显著更高（OR 8.2，P<0.001）。CPAP治疗6个月后，较低的平均夜间CPAP使用率和基线时嗜睡的存在与主观和客观嗜睡过度独立相关。
We evaluated factors associated with subjective and objective sleepiness at baseline and after 6 months of continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnea (OSA). We analyzed data from the Apnea Positive Pressure Long-term Efficacy Study (APPLES), a prospective 6-month multicenter randomized controlled trial with 1105 subjects with OSA, 558 of who were randomized to active CPAP. Epworth sleepiness scores (ESS) and the mean sleep latency (MSL) on the maintenance of wakefulness test at baseline and after 6 months of CPAP therapy were recorded. Excessive sleepiness (ESS > 10) was present in 543 (49.1%) participants. Younger age, presence of depression and higher apnea-hypopnea index (AHI) were associated with higher ESS scores and lower MSL. Randomization to the CPAP group was associated with lower odds of sleepiness at 6-months. The prevalence of sleepiness was significantly lower in those using CPAP >4hours /night versus using CPAP ≤4 hours a night. Among those with good CPAP adherence, those with ESS >10 at baseline had significantly higher odds (OR 8.2, P<0.001) of persistent subjective sleepiness. Lower average nightly CPAP use and presence of sleepiness at baseline were independently associated with excessive subjective and objective sleepiness after 6 months of CPAP therapy.
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影响因子：
3.2
作者：
Edwards BA;O'Driscoll DM;Ali A;Jordan AS;Trinder J;Malhotra A
通讯作者：
Malhotra A
影响因子：
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