The effect of adherence with long-term PAP therapy on the psycho-emotional state of patients with obstructive sleep apnea syndrome

Aim. To assess the impact of adherence and effectiveness of long-term positive airway pressure therapy (PAP-therapy) on the clinical and psychological characteristics of patients with obstructive sleep apnea syndrome. Materials and methods. The study included 80 patients who were examined in the...

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Autores principales: E. M. Elfimova, O. O. Mikhailova, N. T. Khachatryan, I V Starostin, A. Yu. Litvin, I. E. Сhazova
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Publicado: IP Morozov P.V. 2020
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spelling oai:doaj.org-article:475db8ffa9eb4c16b19d6681e23ee6962021-11-30T16:09:16ZThe effect of adherence with long-term PAP therapy on the psycho-emotional state of patients with obstructive sleep apnea syndrome2075-082X2542-218910.26442/2075082X.2020.2.200176https://doaj.org/article/475db8ffa9eb4c16b19d6681e23ee6962020-09-01T00:00:00Zhttps://syst-hypertension.ru/2075-082X/article/viewFile/42248/pdfhttps://doaj.org/toc/2075-082Xhttps://doaj.org/toc/2542-2189Aim. To assess the impact of adherence and effectiveness of long-term positive airway pressure therapy (PAP-therapy) on the clinical and psychological characteristics of patients with obstructive sleep apnea syndrome. Materials and methods. The study included 80 patients who were examined in the sleep apnea laboratory of the Myasnikov Institute of Clinical Cardiology of the National Medical Research Center for Cardiology and who have been on PAP-therapy for more than 12 months. The average age of the patients was 65.0 years [59.0; 71.0], body mass index 35.0 kg/m2 [31.0; 38.0], sleep apnea-hypopnea index (AHI) 39.5/h [31.0; 62.6]. The average duration of PAP therapy was 3.5 years [2.0; 6.0], while the minimum use was 1 year, the maximum 15 years. In the sample of patients who came in person, the percentage of days using PAP-therapy was 87.5% [62.0; 98.0] and the average usage time 6.3 hours [5.2; 7.3]. Results. On long-term PAP-therapy a persistent decrease in AHI was seen on average from 39.5/h [31.0; 62.6] to 2.7/h [1.2; 6.2], p=0,000. The criteria for good adherence to PAP-therapy (use 4 hours/night, more than 70% of nights) were met by the percentage of days of use by 67.5% of patients, the average time of use by 87.5% of patients. Both criteria for good adherence to PAP-therapy was met by 64.8% of patients. With long-term PAP-therapy, 71.7% of patients met the criteria of effectiveness (AHI5/h), AHI remained 5/h in 22.9% of patients and the average residual AHI was 10/h in 5.4% of patients. Correlation analysis showed associations between the PAP-therapy usage parameters and the severity of obstructive sleep apnea syndrome, and sleep quality: percentage of days of use and AHI (r=0.374, p=0.001), average time of use and PSQI (r=-0.438, p=0.000). Patients with a lower adherence to PAP-therapy (63.0% of days [22.0; 96.0] and 3.6 hours [2.4; 4.5] of use) did not differ in daytime sleepiness (ESS 5.0 points [2.0; 9.0] and 5.0 points [3.0; 8.0 ], p=0.891), but had a significantly lower quality of sleep (PSQI): 18.0 points [14.0; 20.0] versus 10.0 points [7.0; 18.0], p=0.004 compared with patients with high adherence to PAP-therapy (98.0% of the days [92.0; 99.0] and 7.9 hours [7.5; 8.2] of use). Conclusions. Patients with the higher adherence to PAP-therapy had significantly better sleep quality. But even the use of PAP-therapy for less than 4 hours is associated with a decrease in daytime sleepiness severity.E. M. ElfimovaO. O. MikhailovaN. T. KhachatryanI V StarostinA. Yu. LitvinI. E. СhazovaIP Morozov P.V.articleobstructive sleep apnea syndromepap-therapyquality of life, quality of sleeplong-term useadherenceDiseases of the circulatory (Cardiovascular) systemRC666-701RUСистемные гипертензии, Vol 17, Iss 2, Pp 56-60 (2020)
institution DOAJ
collection DOAJ
language RU
topic obstructive sleep apnea syndrome
pap-therapy
quality of life, quality of sleep
long-term use
adherence
Diseases of the circulatory (Cardiovascular) system
RC666-701
spellingShingle obstructive sleep apnea syndrome
pap-therapy
quality of life, quality of sleep
long-term use
adherence
Diseases of the circulatory (Cardiovascular) system
RC666-701
E. M. Elfimova
O. O. Mikhailova
N. T. Khachatryan
I V Starostin
A. Yu. Litvin
I. E. Сhazova
The effect of adherence with long-term PAP therapy on the psycho-emotional state of patients with obstructive sleep apnea syndrome
description Aim. To assess the impact of adherence and effectiveness of long-term positive airway pressure therapy (PAP-therapy) on the clinical and psychological characteristics of patients with obstructive sleep apnea syndrome. Materials and methods. The study included 80 patients who were examined in the sleep apnea laboratory of the Myasnikov Institute of Clinical Cardiology of the National Medical Research Center for Cardiology and who have been on PAP-therapy for more than 12 months. The average age of the patients was 65.0 years [59.0; 71.0], body mass index 35.0 kg/m2 [31.0; 38.0], sleep apnea-hypopnea index (AHI) 39.5/h [31.0; 62.6]. The average duration of PAP therapy was 3.5 years [2.0; 6.0], while the minimum use was 1 year, the maximum 15 years. In the sample of patients who came in person, the percentage of days using PAP-therapy was 87.5% [62.0; 98.0] and the average usage time 6.3 hours [5.2; 7.3]. Results. On long-term PAP-therapy a persistent decrease in AHI was seen on average from 39.5/h [31.0; 62.6] to 2.7/h [1.2; 6.2], p=0,000. The criteria for good adherence to PAP-therapy (use 4 hours/night, more than 70% of nights) were met by the percentage of days of use by 67.5% of patients, the average time of use by 87.5% of patients. Both criteria for good adherence to PAP-therapy was met by 64.8% of patients. With long-term PAP-therapy, 71.7% of patients met the criteria of effectiveness (AHI5/h), AHI remained 5/h in 22.9% of patients and the average residual AHI was 10/h in 5.4% of patients. Correlation analysis showed associations between the PAP-therapy usage parameters and the severity of obstructive sleep apnea syndrome, and sleep quality: percentage of days of use and AHI (r=0.374, p=0.001), average time of use and PSQI (r=-0.438, p=0.000). Patients with a lower adherence to PAP-therapy (63.0% of days [22.0; 96.0] and 3.6 hours [2.4; 4.5] of use) did not differ in daytime sleepiness (ESS 5.0 points [2.0; 9.0] and 5.0 points [3.0; 8.0 ], p=0.891), but had a significantly lower quality of sleep (PSQI): 18.0 points [14.0; 20.0] versus 10.0 points [7.0; 18.0], p=0.004 compared with patients with high adherence to PAP-therapy (98.0% of the days [92.0; 99.0] and 7.9 hours [7.5; 8.2] of use). Conclusions. Patients with the higher adherence to PAP-therapy had significantly better sleep quality. But even the use of PAP-therapy for less than 4 hours is associated with a decrease in daytime sleepiness severity.
format article
author E. M. Elfimova
O. O. Mikhailova
N. T. Khachatryan
I V Starostin
A. Yu. Litvin
I. E. Сhazova
author_facet E. M. Elfimova
O. O. Mikhailova
N. T. Khachatryan
I V Starostin
A. Yu. Litvin
I. E. Сhazova
author_sort E. M. Elfimova
title The effect of adherence with long-term PAP therapy on the psycho-emotional state of patients with obstructive sleep apnea syndrome
title_short The effect of adherence with long-term PAP therapy on the psycho-emotional state of patients with obstructive sleep apnea syndrome
title_full The effect of adherence with long-term PAP therapy on the psycho-emotional state of patients with obstructive sleep apnea syndrome
title_fullStr The effect of adherence with long-term PAP therapy on the psycho-emotional state of patients with obstructive sleep apnea syndrome
title_full_unstemmed The effect of adherence with long-term PAP therapy on the psycho-emotional state of patients with obstructive sleep apnea syndrome
title_sort effect of adherence with long-term pap therapy on the psycho-emotional state of patients with obstructive sleep apnea syndrome
publisher IP Morozov P.V.
publishDate 2020
url https://doaj.org/article/475db8ffa9eb4c16b19d6681e23ee696
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