RT期刊文章SR电子T1子的影响optimal adherence of CPAP therapy on symptoms of obstructive sleep apnoea: a randomised, double-blind, controlled trial JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 1901526 DO 10.1183/13993003.01526-2019 VO 55 IS 3 A1 Gaisl, Thomas A1 Rejmer, Protazy A1 Thiel, Sira A1 Haile, Sarah R. A1 Osswald, Martin A1 Roos, Malgorzata A1 Bloch, Konrad E. A1 Stradling, John R. A1 Kohler, Malcolm YR 2020 UL //www.qdcxjkg.com/content/55/3/1901526.abstract AB Introduction Continuous positive airway pressure (CPAP) is currently the treatment of choice for sleepiness in patients with obstructive sleep apnoea (OSA); however, adherence is often thought to be suboptimal. We investigated the effects of suboptimal CPAP usage on objective and subjective sleepiness parameters in patients with OSA.Material and methods In this 2-week, parallel, double-blind, randomised controlled trial we enrolled moderate-to-severe OSA patients with excessive pre-treatment daytime sleepiness (Epworth sleepiness scale (ESS) score >10 points) who had suboptimal CPAP adherence over ≥12 months (mean nightly usage time 3–4 h). Patients were allocated through minimisation to either subtherapeutic CPAP (“sham CPAP”) or continuation of CPAP (“therapeutic CPAP”). A Bayesian analysis with historical priors calculated the posterior probability of superiority.Results Between May, 2016 and November, 2018, 57 patients (aged 60±8 years, 79% male, 93% Caucasian) were allocated in total, and 52 who completed the study (50% in each arm) were included in the final analysis. The unadjusted ESS score increase was 2.4 points (95% CI 0.6–4.2, p=0.01) in the sham-CPAP group when compared to continuing therapeutic CPAP. The probability of superiority of therapeutic CPAP over sham CPAP was 90.4% for ESS, 90.1% for systolic blood pressure and 80.3% for diastolic blood pressure.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.Patients with obstructive sleep apnoea and daytime sleepiness are still getting a substantial benefit from suboptimal CPAP adherence (i.e. 3–4 h per night), albeit not as much as they might get if they adhered more http://bit.ly/2Phgeo2