Sex differences in the effectiveness and affecting factors to adherence of continuous positive airway pressure therapy

Sex differences in the effectiveness and affecting factors to adherence of continuous positive airway pressure therapy
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持续气道正压通气治疗依从性效果及影响因素的性别差异

DOI:
10.1007/s41105-021-00355-4
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发表时间:
2022
影响因子:
1.1
通讯作者:
Chishaki A
Chishaki A
中科院分区:
医学4区
文献类型:
--
作者:
Fujita K;Chishaki H,Ando S;Chishaki A

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虽然阻塞性睡眠呼吸暂停(OSA)患者临床背景的性别差异是众所周知的,但关于影响持续正压通气(CPAP)的影响因素的性别差异的研究非常稀少。我们的目的是调查CPAP使用对治疗依从性的性别差异的影响。我们回顾了348名继续使用CPAP至少一年的患者(264名男性,中位年龄58岁)的人口统计学数据、临床特征、阻塞性睡眠呼吸暂停相关症状以及使用CPAP的效果和依从性。CPAP依从性差被定义为在开始CPAP后1年内退出或平均累计使用CPAP少于4小时/晚。通过多因素Logistic回归分析,对CPAP依从性的预测因素或影响因素进行了研究。女性患者年龄较高,OSA严重程度较低。虽然依从性本身在两性之间没有显著差异,但影响因素是不同的。OSA的严重程度,如呼吸暂停低通气指数和嗜睡,以及使用CPAP的许多影响(呼吸困难、难以适应CPAP使用、觉醒改善、夜尿减少和容易适应CPAP)只影响男性患者的坚持。男女患者依从性差的共同因素是较低的年龄、使用CPAP导致的失眠以及白天嗜睡的改善。没有其他特定因素预测女性的依从性较差。我们发现,影响CPAP依从性的因素不仅在阻塞性睡眠呼吸暂停综合征的临床特征上存在性别差异,而且在使用CPAP的有效性和副作用方面也存在性别差异。
Although sex differences in clinical backgrounds of patients with obstructive sleep apnea (OSA) are well known, studies of sex differences about the influencing factors on adherence to continuous positive airway pressure (CPAP) are very sparse. Our aim was to investigate the effects of CPAP use affecting therapeutic adherence in sex differences. We retrospectively assessed demographic data, clinical characteristics, OSA-related symptoms, and effects and adherence of CPAP use in 348 patients (264 males, median age 58 years) who continued CPAP for at least 1 year. Poor adherence was defined as CPAP dropout within 1 year after starting CPAP or the average cumulative CPAP use less than four hours/night. We also studied the predictors or influencing factors of CPAP adherence by multivariate logistic regression analyses. Age was higher and the severity of OSA was lower in female patients. Although the adherence level itself was not significantly different between both sexes, influencing factors were different. OSA severity, such as apnea–hypopnea index and sleepiness, and many effects from CPAP use (respiratory difficulty, difficult adaptation to CPAP use, improved awakening, reduced nocturia, and easy adaptation to CPAP) influenced adherence only in men. Common factors of poor adherence in both sexes were lower age, insomnia by CPAP use, and improved daytime sleepiness. No other specific factors predicted poor adherence in women. We found that there were sex differences in influencing factors on CPAP adherence not only in clinical characteristics of OSA, but also in effectiveness and side effects of CPAP use.
男性和女性睡眠呼吸暂停患者的术前差异
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DOI: 10.1093/sleep/30.3.320
发表时间: 2007
期刊: Sleep
影响因子: 5.6
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发表时间: 1999-04-01
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DOI: --
发表时间: 2005
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