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首页> 外文期刊>Patient Preference and Adherence >Effect of adherence on daytime sleepiness, fatigue, depression and sleep quality in the obstructive sleep apnea/hypopnea syndrome patients undertaking nasal continuous positive airway pressure therapy
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Effect of adherence on daytime sleepiness, fatigue, depression and sleep quality in the obstructive sleep apnea/hypopnea syndrome patients undertaking nasal continuous positive airway pressure therapy

机译：坚持治疗对持续鼻气道正压通气治疗的阻塞性睡眠呼吸暂停/呼吸不足综合征患者白天嗜睡，疲劳，抑郁和睡眠质量的影响

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Objectives: The aims of this study were to describe changes in day- and nighttime symptoms and the adherence to nasal continuous positive airway pressure (nCPAP) during the first 3-month nCPAP therapy among newly diagnosed patients with obstructive sleep apnea/hypopnea syndrome (OSAS) and to identify the effect of adherence on the changes in day- and nighttime symptoms during the first 3?months. Methods: Newly diagnosed OSAS patients were consecutively recruited from March to August 2013. Baseline clinical information and measures of the Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Zung’s Self-Rating Depression Scale (SDS) and the Pittsburgh Sleep Quality Index (PSQI) at baseline and the end of 3rd, 6th, 9th and 12th week of therapy were collected. Twelve weeks’ adherence was calculated as the average of each 3-week period. Mixed model was used to explore the effect of adherence to nCPAP therapy on ESS, FSS, SDS and PSQI in each 3-week phase. Results: Seventy-six patients completed the 12-week follow-up. The mixed-effects models showed that under the control of therapy phase adherence in the range of <4?hours per night, using nCPAP could independently improve daytime sleepiness, in terms of ESS (coefficient, [95% confidence interval] unit; –4.49 [–5.62, –3.36]). Adherence at 4–6?hours per night could independently improve all variables of day- and nighttime symptoms included in this study, namely?ESS?–6.69 (–7.40, –5.99), FSS –6.02 (–7.14, –4.91), SDS –2.40 (–2.95, –1.85) and PSQI –0.20 (–0.52, –0.12). Further improvement in symptoms could be achieved at ≥6?hours per night using nCPAP, which was ESS –8.35 (–9.26, –7.44), FSS –10.30 (–11.78, –8.83), SDS –4.42 (–5.15, –3.68) and PSQI –0.40 (–0.82, –0.02). The interaction between adherence level and therapy phase was not significant in day- and nighttime symptoms. Conclusion: The effect of adherence on the above-mentioned symptoms is stable through the first 3?months. Under the control of therapy phase, the nCPAP therapy effectively improves day- and nighttime symptoms with ≥4?hours adherence, and the patients can achieve a further improvement with ≥6?hours adherence.
机译：目的：本研究的目的是描述初诊阻塞性睡眠呼吸暂停/呼吸不足综合征（OSAS）的前三个月nCPAP治疗期间白天和夜间症状的变化以及对鼻持续气道正压通气（nCPAP）的依从性），并确定在最初3个月内坚持治疗对白天和夜间症状变化的影响。方法：从2013年3月至2013年8月连续招募新诊断的OSAS患者。其基本临床信息和测量指标包括爱泼华嗜睡量表（ESS），疲劳严重程度量表（FSS），宗格自评抑郁量表（SDS）和匹兹堡睡眠质量收集基线，治疗第3、6、9和12周结束时的指数（PSQI）。坚持12周作为每个3周周期的平均值。混合模型用于探讨在每个3周阶段坚持nCPAP治疗对ESS，FSS，SDS和PSQI的影响。结果：76名患者完成了为期12周的随访。混合效应模型表明，在治疗阶段依从性的控制下，在每晚<4小时的范围内，使用nCPAP可以独立地改善白天的嗜睡程度，以ESS表示（系数，[95％置信区间]单位; –4.49 [–5.62，–3.36]）。每晚4–6小时坚持治疗可以独立改善本研究中日夜症状的所有变量，即ESS？–6.69（–7.40，–5.99），FSS –6.02（–7.14，–4.91）， SDS –2.40（–2.95，–1.85）和PSQI –0.20（–0.52，–0.12）。使用nCPAP，每晚≥6小时，可以进一步改善症状，分别为ESS –8.35（–9.26，–7.44），FSS –10.30（–11.78，–8.83），SDS –4.42（–5.15，–3.68） ）和PSQI –0.40（–0.82，–0.02）。在白天和晚上的症状中，依从性水平和治疗阶段之间的相互作用不显着。结论：坚持治疗对上述症状的影响在最初的​​3个月内是稳定的。在治疗阶段的控制下，nCPAP治疗可以有效地改善昼夜症状，坚持治疗时间≥4小时，并且患者可以达到≥6小时治疗时间进一步改善。

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