Efficacy of intensive treatment by automatic continuous positive airway pressure in elderly patients with obstructive sleep apnea-hypopnea syndrome / 中华老年医学杂志

ABSTRACT

Objective To investigate the efficacy of the hospital intensive treatment by auto-CPAP on elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to analyse the possible factors related to the effectiveness.Methods Subjects were selected from elderly OSAHS patients over 60 years old.The eligible subjects were divided into intensive treatment group and non-intensive treatment group (non-ITG).Patients in intensive treatment group were intensively treated using auto-CPAP for 3 consecutive days,assisted with targeted health education and guidance,and making proper adjustments to parameters of the auto-CPAP according to treatment outcomes at the previous day.But those in non-intensive treatment group were just treated with auto-CPAP for only 1 day,supplemented by regular health education and guidance.The apnea-hypopnea index (AHI),minimum oxygen saturation (SaO2min),mean oxygen saturation (SaO2mean) and the time spent at SaO2 lower than 90％ (tSaO2＜90％),the occurrence of clinical symptoms and adverse effect,Epworth sleepiness scale(ESS) were compared between both groups.The correlation analyses were also conducted.Results ESS (3.58±3.76 vs.6.84 ± 3.22),AHI [(7.85±6.53) time/h vs.(10.42±7.27) time/h] and tSaO2＜90％[(5.65±15.43) min vs.(15.26±33.14) min] were lower(t=6.902,2.760,2.765,allP＜0.05),while SaO2mean [(96.57±1.53)％ vs.(94.63±1.38)％] and SaO2min [(88.24±4.43)％ vs.(83.28±5.06)％]were higher(t=-9.870,-7.740,both P＜0.05)in intensive treatment group than in non intensive treatment group.The occurrences of clinical symptoms and adverse effect (except for skin allergy) were decreased in intensive treatment group versus non-ITG (all P＜0.05).The AHI after intensive treatment was decreased in females versus males [(7.85±5.19) times /h vs.(11.27±7.78) times/h,t=2.133,P＜0.05].BMI,age,gender and the state of OSAHS were correlated to AHI,SaO2 mean,SaO2 min and tSao2＜90％ after intensive treatment (all P＜0.05).Conclusions The hospital intensive treatment can improve the clinical results and decrease the occurrences of clinical symptoms and adverse effect for elderly OSAHS patients,and is expected to improve therapy compliance,and its curative efficacy is correlated to BMI,age,gender and state of OSAHS before therapy.