Influence of Marital Status and Employment Status on Long-Term Adherence with Continuous Positive Airway Pressure in Sleep Apnea Patients

) of consecutive OSAHS patients in whom CPAP had been prescribed for at least 90 days, we studied the impact on long-term treatment adherence of socioeconomic factors, patients and disease characteristics prior to CPAP initiation. living alone; p = 0.01). Age, gender, Epworth sleepiness scale, depressive syndrome, associated cardiovascular morbidities, educational attainment and occupation category did not influence CPAP adherence.Marital status and employment status are independent factors of CPAP adherence in addition to BMI and disease severity. Patients living alone and/or working patients are at greater risk of non-adherence, whereas adherence is higher in married and retired patients. These findings suggest that the social context of daily life should be taken into account in risk screening for CPAP non-adherence. Future interventional studies targeting at-risk patients should be designed to address social motivating factors and work-related barriers to CPAP adherence

Tolérance et efficacité de la ventilation non invasive à domicile chez 44 patients âgés de 75 ans et plus

Objectif : valider l' indication de la mise en route d' une ventilation non invasive à domicile chez les patients âgés de 75 ans et plus. Méthode : étude rétrospective de ces patients âgés appareillés dans le service de 1992 à 2002, étude prospective des patients appareillés du 1/08/2002 au 1/08/2003 et âgés de 75 ans et plus. Pour chaque patient nous avons renseigné un vaste questionnaire constitué de deux parties principales : un bilan somatique et un bilan psychosocial. Résultats : la tolérance et l' efficacité sont bonnes et comparables aux patients plus jeunes. Conclusion : Ventiler de façon non invasive à domicile les patients à un âge supérieur ou égal à 75 ans semble donc licite pour une partie sélectionnée de ces patients.NANTES-BU Médecine pharmacie (441092101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Ventilation non invasive par aide inspiratoire à domicile (le réglage de la fréquence respiratoire influence-t-il le mode ventilatoire des patients)

Nous rapportons une étude rétrospective portant sur 91 patients insuffisants respiratoires chroniques bénéficiant d une ventilation non invasive (VNI) à domicile en aide inspiratoire avec fréquence de sécurité (BiPAP mode S/T). Nous avons étudié le taux de déclenchement des respirateurs par les patients. Nous avons trouvé une corrélation entre le réglage de la fréquence respiratoire de sécurité (FRs), de la pression inspiratoire (IPAP), de la pression expiratoire (EPAP) et le taux de déclenchement du respirateur. Nous n avons pas mis en évidence de différence de taux de déclenchement en fonction de l étiologie. Les patients adoptant la fréquence respiratoire de sécurité se trouvent dans un mode de ventilation assistée contrôlée en pression. Nous pensons que cette situation favorise la mise au repos des muscles respiratoires et donc l efficacité de la VNI au long cours. Cette conclusion doit être confirmée par une étude prospective.NANTES-BU Médecine pharmacie (441092101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Dehydration kinetics of talc and 10 Å phase: Consequences for subduction zone seismicity

International audienc

Noninvasive Ventilation in Obese Subjects After Acute Respiratory Failure

International audienc

Depressive Symptoms Before and After Long-term CPAP Therapy in Patients With Sleep Apnea

International audienceBACKGROUND:The outcome of depressive symptoms under CPAP therapy for OSA-hypopnea syndrome (OSAHS) has been poorly evaluated. In this multicenter, prospective cohort study, we evaluated the prevalence and correlates of persistent depressive symptoms after long-term CPAP therapy for OSAHS.METHODS:This study included 300 patients with OSAHS and depressive symptoms (13-item, self-rated Pichot depression scale [QD2A] ≥ 7) at diagnosis. The primary dependent variable was persistent depressive symptoms after ≥ 1 year of CPAP therapy. Multivariate regression analyses were performed to determine variables independently associated with the persistence of depressive symptoms.RESULTS:After an average of 529 days (range, 365-1,569 days) of CPAP therapy, the mean (SD) QD2A score decreased from 9.2 (2.0) to 5.4 (4.0) (P &amp;lt; .0001), but 125 patients (41.7%) presented persistent depressive symptoms. The persistence of depressive symptoms was independently associated with persistent excessive daytime sleepiness (EDS) (OR, 2.72; 95% CI, 1.33-5.61), comorbid cardiovascular disease (OR, 1.76; 95% CI, 1.02-3.00), and female sex (OR, 1.53; 95% CI, 1.09-2.13). A positive linear trend was observed for the adjusted OR of persistent depressive symptoms with decreasing CPAP effect on the Epworth sleepiness scale (P &amp;lt; .0001).CONCLUSIONS:CPAP therapy does not resolve depressive symptoms in many patients with OSAHS. Persistent depressive symptoms are strongly associated with EDS. Active monitoring of depressive symptoms is needed in patients with OSAHS who are treated with CPAP. Interventional trials are required to evaluate the impact of antidepressants, cognitive behavioral therapy, or both on comorbid depression in patients with OSAHS.</p

Adherence to positive airway pressure in non-sleepy patients with obstructive sleep apnoea.

International audienceComplaints of excessive daytime sleepiness (EDS) are absent in many individuals with obstructive sleep apnoea (OSA). The influence of EDS prior to treatment on continuous positive airway pressure (CPAP) adherence has not been clearly determined [1, 2]. The aim of this prospective cohort study was to evaluate the adherence and perceived benefit during long-term CPAP therapy in a "real life" population of non-sleepy OSA patients.</p

Home Non-Invasive Ventilation Fails to Improve Quality of Life in the Elderly: Results from a Multicenter Cohort Study

International audienc

Baseline characteristics of adherent and non-adherent patients.^*

<p>*Results presented as mean (standard deviation) unless otherwise indicated.</p><p>Adherent patients: continuous positive airway pressure (CPAP) use ≥4 h/night.</p><p>Non-adherent patients: CPAP refused or abandoned, or CPAP use<4 h/night.</p><p>Significant level for p value: <0.05.</p