Study Objectives:

This study examined the association between age and CPAP acceptance in a consecutive series of patients with obstructive sleep apnea being managed in a physician-led outpatient CPAP acclimatization program in Canberra, Australia.

Methods:

We performed a retrospective consecutive case series analysis of registry data collected from patients attending the Canberra Hospital PAP Acclimatization Clinic between 2011-2019. Data on patient demographics, diagnostic polysomnography results, CPAP device download parameters during acclimatization, and overall CPAP acceptance at the end of acclimatization was extracted from the Clinic Registry. ANOVA and Chi-square were used to assess for association between patient age, CPAP acceptance and other clinical characteristics. Univariate and stepwise multiple logistic regression was used to identify predictors of CPAP acceptance.

Results:

1,075 consecutive CPAP trials amongst 1,043 patients were eligible for inclusion. CPAP acceptance was lower in those aged >75 years compared to those aged ≤75 years (odds ratio 0.57, 95% confidence interval 0.36-0.92, p=0.02). Patients aged >75 years had lower BMI, higher initial and final visit 95th percentile mask leak and were less likely to be CPAP naïve.

Using univariate regression, younger age, severe OSA, obesity, shorter trial duration, more clinic visits, higher initial visit CPAP usage and lower final visit mask leak were predictors of CPAP acceptance. In a multiple logistic regression model, younger age, severe OSA, shorter trial duration, more clinic visits, higher first visit usage and lower final visit leak predicted acceptance.

Conclusions:

Older age is associated with lower CPAP acceptance. The factors contributing to this association are unclear and requires further investigation.

中文翻译：

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阻塞性睡眠呼吸暂停患者门诊队列中年龄与持续气道正压通气接受度的关联

学习目标：

本研究在澳大利亚堪培拉的医生主导的门诊 CPAP 适应计划中对一系列阻塞性睡眠呼吸暂停患者的年龄和 CPAP 接受度之间的关联进行了研究。

方法：

我们对 2011-2019 年间在堪培拉医院 PAP 适应诊所就诊的患者收集的注册数据进行了回顾性连续病例系列分析。从临床登记处提取有关患者人口统计数据、诊断性多导睡眠图结果、适应期间 CPAP 设备下载参数以及适应结束时总体 CPAP 接受度的数据。方差分析和卡方用于评估患者年龄、CPAP 接受度和其他临床特征之间的关联。使用单变量和逐步多元逻辑回归来确定 CPAP 接受度的预测因子。

结果：

1,043 名患者中的 1,075 项连续 CPAP 试验符合纳入条件。与年龄≤75 岁的人相比，>75 岁的人对 CPAP 的接受度较低（比值比 0.57，95% 置信区间 0.36-0.92，p=0.02）。年龄大于 75 岁的患者 BMI 较低，首次和最终就诊的第 95 个百分位面罩漏气率较高，并且不太可能未使用过 CPAP。

使用单变量回归，年轻、严重的 OSA、肥胖、较短的试验持续时间、更多的门诊就诊、较高的初次就诊 CPAP 使用率和较低的最终就诊面罩泄漏是 CPAP 接受度的预测因素。在多元逻辑回归模型中，年龄较小、严重 OSA、试验持续时间较短、门诊就诊次数较多、首次就诊使用率较高和最终就诊漏诊率较低预示着接受度。

结论：

年龄越大，CPAP 接受度越低。促成这种关联的因素尚不清楚，需要进一步调查。