MULTISITE STUDY OF THE FUNCTIONAL OUTCOMES OF CPAP USE

该项目旨在确定阻塞性睡眠呼吸暂停综合征 经鼻持续正压通气是治疗阻塞性睡眠呼吸暂停综合征（OSAS）最有效的方法。 使用格兰杰（1984）的功能评估模型对患者进行持续气道正压通气（CPAP）。 在世界范围内，CPAP是OSAS的非手术治疗选择。 虽然很明显CPAP改变了生理损伤， 与OSAS相关，其对患者功能的影响， 日常生活仍然不清楚，每小时持续时间的影响， CPAP对日间功能的使用频率知之甚少。 先前对CPAP依从性的调查表明， 不同的使用率，但还没有研究评估的关系 CPAP使用和日间功能之间的关系。 其主要目的是 一个合作的五个地点的项目是前瞻性地研究一个大的队列 针对OSAS和嗜睡严重程度不同的患者，提供 关于每小时持续时间和 CPAP使用频率和日间功能改善。 这 该项目将前瞻性研究患有三种程度OSAS的患者 严重程度（英里，中度，严重）和两个级别的生理 CPAP治疗前后三个月的嗜睡情况。 一 包含微处理器的监视器将用于客观地跟踪 CPAP使用。 通过评估日间功能的多方面 （生理睡眠倾向、主观嗜睡、情绪、 神经行为表现和功能状态），我们将描述 OSAS患者治疗前后觉醒障碍的性质 CPAP治疗。 我们将检验假设， 治疗，那些患有更严重的OSAS和/或更严重的 生理上的困倦在白天会有最大的缺陷 功能 该项目将确定CPAP之间的关系 与疾病严重程度相关的日间功能的使用和改善 和治疗前嗜睡的水平。 这项研究将提供 关于最小小时持续时间和频率的宝贵信息 CPAP使用的必要性，以产生日间功能的变化， 这些使用模式在多大程度上是司空见惯的。 这些信息将 有助于理解如何 CPAP使用的实际患者选择模式涉及治疗性 重要目标，并将确定与最大限度地 CPAP治疗OSAS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.