Correlation Between OSA With Chronic Cough And CPAP Therapeutic Compliance

Objective:To discuss the relationship between obstructive sleep apnea(OSA) and chronic cough. To discuss the difference between patients with and without compliance in improving cough, with continuous positive airway pressure(CPAP) in patients with sleep apnea combined with chronic cough.Methods:1.Retrospective investigation of patients with obstructive sleep apnea(OSA) who were diagnosed by polysomnography(PSG) at the sleep medical center of the department of Respiratory medicine in Tianjin Medical University General Hospital from January 2010 to March 2015. Of all the patients, 1420 were male and 383female(range 29 to 75 years).(1)All patients should complete the questionnaires about sleep apnea epidemiological survey.(2)All of the patients combined with chronic cough should complete The Cough Visual Score(VAS) and Leicester Cough Questionnaire(LCQ).(3)The baseline, the sleep test report after 1-year of follow-up,the cough questionnaires and other relative clinical data of OSA patients combined with chronic cough that were treated by continuous positive airway pressure(CPAP)were analyzed.t were treated by continuous positive airway pressure(CPAP) were analyzed.2.(1) We study all the OSA patients on general information, upper respiratory airway anomalies and the proportion of common symptoms.(2)The upper respiratory airway anomalies and the proportion of common symptoms between OSA patients combined with or without chronic cough were statistical by chi-square test.(3)Of the OSA patients with chronic cough treated by continuous positive airway pressure(CPAP)and followed-up for 1-year with no complications and smoking history, the difference of Apnea Hyponea Index(AHI),the mean blood oxygen saturation in night(Sp O2mean)and the improvement of chronic cough between patients with and without compliance were compared.Results:1.In 1803 patients with OSA, a total of 456 cases were combined with chronic cough.The chronic obstructive pulmonary disease, acute attack of asthma, and pulmonary substantial disease patients were ruled out by lung function and chest imaging examination.2. The OSA patients combined with chronic cough had higher symptoms percentage such as heartburn and sour regurgitation, thirsty, paroxysmal dyspnea, suppress wake at night compared with who didn't have chronic cough, chi-square values were respectively 76.91, 20.29, 55.40, 20.29, p < 0.001. Nasal disease and pharyngeal cavity stenosis percentage were also significantly higher, with chi-square value is19.11, 19.82, p < 0.001, with statistical significance.3.The correlation coefficient between The Cough Visual Score(VAS) of OSA patients combined with chronic cough and AHI, Sp O2 mean, ESS, BMI, neck circumference,snoring time of them were respectively 0.167,-0.178, 0.167, 0.124, 0.106, 0.124.The correlation coefficient between Leicester Cough Questionnaire(LCQ) and AHI,Sp O2 mean, ESS, BMI, neck circumference, snoring time of them were respectively-0.172?0.185?-0.147?-0.094?-0.089?-0.081,p < 0.05, all have statistical significance.4.The OSA patients combined with chronic cough adhered to the treatment of CPAP for 1 year were 111, good compliance group were 49, poor compliance group 62.The two groups baseline in AHI ? Sp O2 mean ? VAS ? LCQ have no statistical significance(p>0.05).Compared with good compliance group and the poor to CPAP therapy, followed up for 3 months, 6 months, 12 months, two groups of AHI respectively(34.20 ±21.05 vs. 43.42 ±34.20),(25.56 ± 17.87 vs. 40.08±26.21),(15.34±13.11 vs. 36.02±25.75), t were respectively 1.963, 3.369, 5.313, two groups of Sp O2 mean respectively( 80.22±23.15 vs 76.42±24.41) ?( 87.36±19.26 vs81.26±21.34)?(93.34±15.12 vs 83.02±25.75), t were respectively 1.663 ?4.219?6.213,p<0.05,so the AHI and Sp O2 mean of good compliance group improved more apparently, with statistical significance. Followed up for 6 months, 12 months, two groups of VAS respectively( 24.29±15.00 vs 39.82±22.40)( 13.47±12.17 vs34.74±21.22), t were respectively-4.246?-6.345, two groups of LCQ respectively(5.94±0.86 vs 5.32±1.03)(6.38±0.78 vs 5.49±0.99),t were respectively 3.366?5.213, p<0.05,so the VAS and LCQ of good compliance group improved more apparently, with statistical significance.Conclusions:1. Of all the cases in the paper, 25.52% of OSA patients were combined with chronic cough.2. The OSA patients combined with chronic cough had higher symptoms percentage such as heartburn and sour regurgitation, thirsty, paroxysmal dyspnea, suppress wake at night compared with who didn't have chronic cough.3. The chronic cough is correlated with the AHI, Sp O2 mean, ESS, BMI, neck circumference, snoring time of patients, which may cause or aggravate patients coughing directly or indirectly.4. Of the OSA patients combined with chronic cough, the good compliance group to CPAP therapy improves more apparently, suggesting that prompt treatment compliance will significantly relieve cough.