Craniofacial Phenotype in Obstructive Sleep Apnea and Its Impact on Positive Airway Pressure (PAP) Adherence

被引:1
|
作者
Park, Jae-Seon [1 ]
Kwon, Bin [2 ]
Kang, Hyun-Seok [1 ]
Yun, Seong-Jin [1 ]
Han, Sung-Jun [2 ]
Choi, Yeso [2 ]
Kang, Sung-Hun [1 ]
Lee, Mi-Yeon [3 ]
Lee, Kyung-Chul [1 ]
Hong, Seok-Jin [1 ]
机构
[1] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Otorhinolaryngol Head & Neck Surg, Sch Med, Seoul 110746, South Korea
[2] Hallym Univ, Coll Med, Dongtan Sacred Heart Hosp, Dept Otorhinolaryngol Head & Neck Surg, Hwaseong 18450, South Korea
[3] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept R&D Management, Div Biostat,Sch Med, Seoul 03181, South Korea
来源
JOURNAL OF PERSONALIZED MEDICINE | 2023年 / 13卷 / 08期
关键词
sleep apnea; obstructive; continuous positive airway pressure; treatment adherence and compliance; polysomnography; tomography; X-ray computed; cephalometry; hyoid bone; LONG-TERM COMPLIANCE; CPAP THERAPY; NASAL CPAP; LENGTH; COLLAPSIBILITY; OSA;
D O I
10.3390/jpm13081196
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Positive airway pressure (PAP) is an important treatment tool for patients with moderate and severe obstructive sleep apnea (OSA), and adherence to PAP significantly affects treatment outcomes. Disease severity, adverse effects, and psychosocial factors are known to predict medication adherence. Cephalometric parameters have been reported to positively correlate with upper airway collapse. However, research on the correlation between these cephalometric parameters and PAP adherence remains insufficient. This study aimed to identify this relationship. This study included 185 patients with OSA who were prescribed PAP. Polysomnography (PSG) was performed to diagnose OSA, and paranasal sinus computed tomography (PNS CT) was performed to check for comorbidities of the upper airway. In addition, cephalometric parameters such as the hyoid-posterior nasal spine (H-PNS), posterior nasal spine-mandibular plane (PNS-MP), and hyoid-mandibular plane (H-MP) were measured in the midsagittal and axial CT views. Adherence was evaluated 3-12 months after the PAP prescription. A total of 136 patients were PAP-adherent, and 49 were nonadherent. There were more males in the adherent group and a higher average height in the adherent group. The PSG results showed that the apnea-hypopnea index (AHI), respiratory disturbance index (RDI), oxygen desaturation index (ODI), arousal index (AI), rapid eye movement (REM) AHI, and supine AHI were significantly higher, and the lowest oxygen saturation was lower in the adherent group. In the analysis of covariance (ANCOVA) model adjusted for sex and height, among the cephalometric parameters, H-MP was significantly longer in the adherent group (p = 0.027), and H-PNS showed a longer tendency (p = 0.074). In the logistic regression analysis model, the odds ratio (OR) and 95% confidence intervals (95% CI) of adherence and severe OSA in the third tertile compared to the first tertile of H-MP were 2.93 (1.25-6.86) and 4.00 (1.87-8.56). In the case of H-PNS, they were 2.58 (1.14-5.81) and 4.86 (2.24-10.54), respectively. This study concluded that an inferiorly placed hyoid bone in adult patients is associated with PAP adherence and disease severity.
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页数:13
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