STUDY OBJECTIVES Many studies have already looked at factors that may influence adherence to continuous positive airway pressure (CPAP) (severity of obstructive sleep apnea (OSA), patients' age, technical aspects, socio-economic factors, living conditions, psychological factors). Although it has been shown that individuals' preference for risky behaviors in daily life can influence the use of care or adherence to drug therapies in care settings, this has never been tested in OSA. This study aims to analyze the association between risk attitude in the health/safety domain and CPAP discontinuation in a cohort of OSA patients. METHODS In a prospective multicenter cohort study nested within the IRSR sleep cohort, consecutive patients who were prescribed CPAP were monitored for at least 6 months. In addition to the data usually collected in the IRSR sleep cohort at baseline, patients also completed a risk-taking questionnaire using the DOSPERT scale. Cox's proportional hazards regression was used to model the risk of CPAP discontinuation as a function of a linear combination of variables hypothetically related to this risk including health risk attitude. RESULTS Of the 489 patients under CPAP, 12.1% (n=59) were risk-seeking, 87.9% (n=430) were risk neutral, and none were risk-averse. Cox's model indicated that a risk-seeking attitude (p=0.04) an AHI &30 (p&0.01), were significantly associated with CPAP discontinuation. CONCLUSIONS Patients with risk seeking behaviors in daily life have been shown to be more likely to discontinue CPAP. The DOSPERT scale can be a useful tool for screening this specific group of patients in clinical practice.

中文翻译：

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健康和安全领域的风险寻求态度与 OSA 患者停用 CPAP 相关——一项多中心前瞻性队列研究

研究目标 许多研究已经研究了可能影响持续气道正压通气 (CPAP) 依从性的因素（阻塞性睡眠呼吸暂停 (OSA) 的严重程度、患者的年龄、技术方面、社会经济因素、生活条件、心理因素）。尽管已经表明个人在日常生活中对危险行为的偏好会影响护理环境中的护理使用或药物治疗的依从性，但这从未在 OSA 中进行过测试。本研究旨在分析一组 OSA 患者中健康/安全领域的风险态度与停用 CPAP 之间的关联。方法 在一项嵌套在 IRSR 睡眠队列中的前瞻性多中心队列研究中，连续监测接受 CPAP 处方的患者至少 6 个月。除了通常在基线时在 IRSR 睡眠队列中收集的数据外，患者还使用 DOSPERT 量表完成了一份冒险问卷。Cox 的比例风险回归用于将 CPAP 中断的风险建模为假设与该风险相关的变量线性组合的函数，包括健康风险态度。结果 在 CPAP 下的 489 名患者中，12.1% (n=59) 是寻求风险的，87.9% (n=430) 是风险中性的，没有人是风险厌恶的。Cox 模型表明，寻求风险的态度 (p=0.04) 和 AHI &30 (p&0.01) 与 CPAP 停用显着相关。结论 在日常生活中具有寻求风险行为的患者更有可能停止使用 CPAP。