Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning.

摘要: CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) CURRENTLY IS CONSIDERED THE MOST EFFECTIVE TREATMENT FOR OBSTRUCTIVE SLEEP APNEA (OSA). THIS device provides a pneumatic splint to prevent nocturnal airway collapse. In randomized clinical trials that included use of sham CPAP as placebo, treatment with this has been shown produce improvements in symptoms, quality life, sleepiness, neuropsychological performance, and hypertension.1 It also established optimal effectiveness depends on consistent use. Skipping even 1 night reverses daytime response the physiologic measure disease severity, apnea-hypopnea index (AHI).2–4 Although these benefits have trials, there is considerable variation by patients routine practice,5–8 approximately half using it consistently every average 6 hours per other skipping from 7 nights week 3.5 night.5 not known, however, what impact differential therapy practice. may be individuals shorter are, general, less well treated respect outcomes such than are those longer durations Alternatively, might individual need for so that, though some use, they effectively sleepiness. This mediated biologic mechanisms similar recently described sleep deprivation.9 To address question, we conducted multisite study which evaluated status before after 3 months care measurement adherence during entire follow-up period. international capitalized patient heterogeneity regard nightly CPAP, order estimate relationships between likelihood achieving “normal” value salient measures sleepiness functional “dose” received (i.e., night). Because no consensus regarding primary assessment response, chose deemed most applicable management OSA—subjective (Epworth Sleepiness Scale [ESS]10), (Multiple Sleep Latency Test [MSLT]11), disease-specific (Functional Outcomes Questionnaire [FOSQ]12). By evaluating duration relative obtaining normal values impaired each measures, provide data clinician can employ determining within context goals, e.g., reduce improve daily functioning, or both.