Variability of breathing during wakefulness while using CPAP predicts adherence.

• Material Type: 博士論文
• Title: Variability of breathing during wakefulness while using CPAP predicts adherence.
• Author/Editor: Fujita, Yukio; Yamauchi, Motoo; Uyama, Hiroki; Kumamoto, Makiko; Koyama, Noriko; Yoshikawa, Masanori; Strohl, Kingman P.; Kimura, Hiroshi
• Author Heading: Fujita, Yukio; Yamauchi, Motoo; Uyama, Hiroki; Kumamoto, Makiko; Koyama, Noriko; Yoshikawa, Masanori; Strohl, Kingman P.; Kimura, Hiroshi
• Publication, Distribution, etc.: John Wiley & Sons, Inc.
• Publication Date: 2017-02-22
• Publication Date (W3CDTF): 2017-02-22
• Alternative Title: CPAPアドヒランスの予測因子としてのCPAP装着下覚醒時の呼吸不規則性
• Periodical title: Respirology
• No. or year of volume/issue: 22 2
• Volume: 22
• Issue: 2
• Pages: 386-393
• ISSN (Periodical Title): ISSN : 1323-7799
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2017-03-15
• Dissertation Number: 乙第1391号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: breathing regularity; continuous positive airway pressure adherence; obstructive sleep apnoea syndrome; predictive marker; respiratory physiology
• Target Audience: 一般
• Note (General): type:Thesis; BACKGROUND AND OBJECTIVE: The standard therapy for obstructive sleep apnoea (OSA) is continuous positive airway pressure (CPAP) therapy. However, long-term adherence remains at ~50% despite improvements in behavioural and educational interventions. Based on prior work, we explored whether regularity of breathing during wakefulness might be a physiologic predictor of CPAP adherence. METHODS: Of the 117 consecutive patients who were diagnosed with OSA and prescribed CPAP, 79 CPAP naïve patients were enrolled in this prospective study. During CPAP initiation, respiratory signals were collected using respiratory inductance plethysmography while wearing CPAP during wakefulness in a seated position. Breathing regularity was assessed by the coefficient of variation (CV) for breath-by-breath estimated tidal volume (VT ) and total duration of respiratory cycle (Ttot). In a derivation group (n = 36), we determined the cut-off CV value which predicted poor CPAP adherence at the first month of therapy, and verified the validity of this predetermined cut-off value in the remaining participants (validation group; n = 43). RESULTS: In the derivation group, the CV for estimated VT was significantly higher in patients with poor adherence than with good adherence (median (interquartile range): 44.2 (33.4-57.4) vs 26.0 (20.4-33.2), P < 0.001). The CV cut-off value for estimated VT for poor CPAP adherence was 34.0, according to a receiver-operating characteristic (ROC) curve. In the validation group, the CV value for estimated VT >34.0 confirmed to be predicting poor CPAP adherence (sensitivity, 0.78; specificity, 0.83). CONCLUSION: At the initiation of therapy, breathing regularity during wakefulness while wearing CPAP is an objective predictor of short-term CPAP adherence.; 博士（医学）・乙第1391号・平成29年3月15日; © 2016 Asian Pacific Society of Respirology; This is the peer reviewed version of the following article: Respirology Vol.22 No.2 p.386-393 (2017 Feb), which has been published in final form at http://dx.doi.org/10.1111/resp.12900. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.; identifier:Respirology Vol.22 No.2 p.386-393 (2017 Feb); identifier:13237799; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3324; identifier:Respirology, 22(2): 386-393
• Source: fulltext; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3324/1/01_%e4%b9%991391%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3324/2/02_%e4%b9%991391%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3324/10/03%20%e4%b9%991391%e6%9c%ac%e6%96%87.pdf
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1111/resp.12900
• Periodical Title (NCID): AA11097269; https://ci.nii.ac.jp/ncid/AA11097269
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU