폐쇄성 수면무호흡증 환자에서 양압기 치료에 대한 1년 이상 순응군과 비순응군의 비교

Abstract

Background and Objectives: The use of positive airway pressure (PAP) is the treatment of choice for patients with obstructive sleep apnea (OSA), however, poor adherence remains a major cause of treatment failure. The objective of this retrospective study was to compare the differences between adherent and non-adherent groups to auto-titration PAP (APAP) therapy for more than one year in patients with OSA. Materials and Methods: Total 111 patients with OSA who had completed the 3 months compliance assessment for Korean national health insurance coverage were enrolled. They were allocated to adherent (using APAP for more than 12 months) or non-adherent group. Patients’ medical records, polysomnographic data, and APAP use data at the time of passing adaptation period were analyzed, and the differences between the two groups were compared. Results: The number of patients in the adherent group was 66 (59.5%), and the non-adherent group was 45 (40.5%). There were no significant between-group differences in body mass index, Epworth sleepiness scale, apnea-hypopnea index (AHI), and APAP device data by binary logistic regression analysis. However, patients with severe OSA (AHI≥30) were more likely to be compliant with PAP therapy than patients with mild to moderate OSA (odds ratio 3.433, 95% confidence interval 1.329–8.870, p=0.011). Conclusion: The percentage of patients who used APAP devices for more than 12 months was 59.5% in this study. Disease severity (AHI≥30) seems to be a predictor for APAP compliance for more than one year in patients with OSA.