MULTISITE STUDY OF THE FUNCTIONAL OUTCOMES OF CPAP USE

该项目试图确定阻塞性睡眠呼吸暂停综合征是如何 鼻腔持续正压通气是治疗阻塞性睡眠呼吸暂停低通气综合征最有效的方法 压力(CPAP)采用Granger(1984)功能评估模型。 在世界范围内，CPAP是OSAS的非手术治疗选择。 尽管很明显，CPAP改变了生理损伤 与阻塞性睡眠呼吸暂停综合征相关，其对患者功能的影响 日常生活仍然不清楚，每小时持续时间和 人们对白天活动时使用CPAP的频率了解很少。 之前对CPAP遵从性的调查表明 不同的使用率，但还没有研究评估这种关系 CPAP使用和日间功能之间的关系。这样做的主要目的是 合作的五个地点项目是前瞻性地研究一个大的队列 根据OSAS严重程度和嗜睡程度的不同，提供 关于每小时工作时间和工作时间关系的第一个客观数据 使用CPAP的频率和日间功能的改善。这 该项目将前瞻性地研究患有三种程度的OSAS的患者 严重程度(英里、中等、严重)和两个生理水平 CPAP治疗前、后3个月的嗜睡情况。一个 包含微处理器的监视器将用于客观跟踪 CPAP使用率。通过评估日间功能的多维方面 (生理睡眠倾向、主观困倦、情绪、 神经行为表现和功能状态)我们将描述 阻塞性睡眠呼吸暂停综合征患者治疗前后觉醒功能障碍的性质 采用CPAP治疗。我们将检验假设，在此之前 治疗，那些OSAS和/或更严重和/或更严重的患者 生理困倦在白天的缺陷最大。 功能正常。该项目将决定CPAP与 与疾病严重程度相关的白天功能的使用和改进 以及治疗前嗜睡程度。拟议的研究将提供 关于最小每小时持续时间和频率的有价值的信息 必要的CPAP使用，以改变白天的功能并 这些使用模式在多大程度上是司空见惯的。这样的信息将 大大有助于理解以何种方式 患者实际选择的CPAP使用模式与治疗相关 重要的目标，它将确定与最大化相关的关键因素 持续正压通气治疗阻塞性睡眠呼吸暂停综合征的临床疗效

This project seeks to determine how obstructive sleep apnea syndrome (OSAS) is most effectively treated with nasal continuous positive airway pressure (CPAP) using Granger's (1984) model of functional assessment. Worldwide, CPAP is the nonsurgical treatment of choice for OSAS. Although it is clear that CPAP alters the physiological impairments associated with OSAS, its effects on a patient's ability to function in everyday life remain unclear, and the impact of hourly duration and frequency of CPAP use on daytime functioning is poorly understood. Previous investigations of compliance with CPAP have demonstrated variable use rates, but no study has yet evaluated the relationship between CPAP use and daytime functioning. The primary aim of this collaborative five-site project is to prospectively study a large cohort of patients varying in the severity of OSAS and sleepiness, to provide the first objective data on the relationship between hourly duration and frequency of CPAP use and improvement in daytime functioning. This project will prospectively study patients with three degrees of OSAS severity (mile, moderate, severe) and two levels of physiological sleepiness before and after three months of treatment with CPAP. A monitor containing a microprocessor will be used to objectively track CPAP usage. By assessing multidimensional aspects of daytime functioning (physiological sleep tendency, subjective sleepiness, mood, neurobehavioral performance, and functional status) we will characterize the nature of waking impairments in OSAS patients before and after treatment with CPAP. We will test the hypothesis that prior to treatment, those patients with more severe OSAS and/or greater physiological sleepiness will have the greatest deficits in daytime functioning. The project will determine the relationship between CPAP use and improvements in daytime functions relative to disease severity and level of pre-treatment sleepiness. The proposed study will provide valuable information regarding the minimal hourly duration and frequency of CPAP use necessary to produce changes in daytime functioning and to what extent these patterns of use are commonplace. Such information will contribute substantially to an understanding of the manner in which actual patient-selected patterns of CPAP use relate to therapeutically important goals, and it will identify key factors relevant to maximizing the clinical effectiveness of CPAP for OSAS.