cpap治疗依从性不佳对阻塞性睡眠呼吸暂停症状的影响:持续气道正压通气(Continuous positive airway pressure, CPAP)是目前治疗阻塞性睡眠呼吸暂停(OSA)患者困倦的一种选择，然而，依从性通常被认为是次优的。我们调查了不理想的cpp使用对OSA患者客观和主观睡意参数的影响。在这项为期2周的平行、双盲、随机对照试验中，我们纳入了治疗前过度日间嗜睡(epworth - sleep- scale [ESS]评分>10分)的中至重度OSA患者，这些患者在至少12个月(平均每晚使用时间3-4小时)的CPAP治疗依从性不佳。通过最小化的方式将患者分配到亚治疗性CPAP(“假CPAP”)或持续CPAP(治疗性CPAP)。基于历史先验的贝叶斯分析计算了优势的后验概率。2016年5月至2018年11月，共有57例患者(60±8岁，79%男性，93%白人)被分配到最终分析中，52例完成研究的患者(两组各50%)被纳入最终分析。未经调整的ess评分增加了+2.4分(95% CI +0.6至+4.2;p=0.01)。治疗性CPAP优于假性CPAP的概率分别为:ESS 90.4%，收缩压90.1%，舒张压80.3%。Conclusions Patients with moderate-to-severe OSA and daytime sleepiness are still getting a substantial benefit from suboptimal CPAP adherence, albeit not as much as they might get if they adhered more. Whether a similar statement can be made for even lower adherence levels remains to be established in future trials.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Gaisl reports personal fees from Bayer AG (consulting), outside the submitted work.Conflict of interest: Dr. Rejmer has nothing to disclose.Conflict of interest: Dr. Thiel has nothing to disclose.Conflict of interest: Dr. Haile has nothing to disclose.Conflict of interest: Dr. Osswald has nothing to disclose.Conflict of interest: Dr. Roos has nothing to disclose.Conflict of interest: Dr. Bloch has nothing to disclose.Conflict of interest: Dr. Stradling reports personal fees from Bayer AG, personal fees from ResMed, outside the submitted work.Conflict of interest: Dr. Kohler reports personal fees from Bayer AG, grants from University of Zurich, grants from Lunge Zurich, outside the submitted work. %U //www.qdcxjkg.com/content/erj/early/2019/12/04/13993003.01526-2019.full.pdf