TY - JOUR T1 - CPAP治疗依从性不佳对阻塞性睡眠呼吸暂停症状的影响:JF -欧洲呼吸杂志JO - Eur Respir J DO - 10.1188 /13993003.01526-2019 VL - 55 IS - 3 SP - 1901526 AU - Gaisl, Thomas AU - Rejmer, Protazy AU - Thiel, Sira AU - Haile, Sarah R. AU - Osswald, Martin AU - Roos, Malgorzata AU - Bloch, Konrad E. AU - Stradling, John R. AU - Kohler，持续气道正压通气(CPAP)是目前阻塞性睡眠呼吸暂停(OSA)患者嗜睡的首选治疗方法;然而，坚持往往被认为是次优的。我们调查了次优CPAP使用对OSA患者客观和主观嗜睡参数的影响。在这项为期2周的平行、双盲、随机对照试验中，我们招募了治疗前白天嗜睡过度(埃普沃斯嗜睡量表(ESS)评分>10分)的中-重度OSA患者，这些患者在≥12个月(平均每晚使用时间3-4小时)的时间内坚持CPAP不佳。通过最小化，患者被分配到亚治疗性CPAP(“伪CPAP”)或继续CPAP(“治疗性CPAP”)。具有历史先验的贝叶斯分析计算了优势的后验概率。结果2016年5月至2018年11月，共分配57例患者(年龄60±8岁，79%男性，93%白人)，其中52例完成研究(每组50%)纳入最终分析。与持续治疗性CPAP组相比，假性CPAP组未调整ESS评分增加2.4分(95% CI 0.6-4.2, p=0.01)。 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 ER -