Choosing the right mask for your Asian patient with sleep apnoea: A randomized, crossover trial of CPAP interfaces.
Respirology
; 24(3): 278-285, 2019 03.
Article
in En
| MEDLINE
| ID: mdl-30189465
ABSTRACT
BACKGROUND AND OBJECTIVE:
A major challenge with the treatment of obstructive sleep apnoea (OSA) is adherence to continuous positive airway pressure (CPAP) therapy. Mask tolerability is an important determinant of adherence, however evidence to guide selection of mask interfaces is lacking.METHODS:
We conducted a randomized crossover trial of mask interfaces in CPAP therapy for moderate-to-severe OSA to assess adherence and efficacy of CPAP therapy with nasal mask, nasal pillow and oronasal masks. Demographic data, Nasal Obstruction Symptom Evaluation (NOSE) scores and craniofacial measurements were also analysed for associations with adherence with oronasal masks.RESULTS:
Eighty-five patients were included in the study (mean ± SD age 46 ± 12 years; body mass index 29.9 ± 5.6 kg/m2 ; apnoea-hypopnoea index (AHI) 53.6 ± 24.0 events/h). Patients had better adherence with nasal masks (average night use 3.96 ± 2.26 h/night) compared to oronasal masks (3.26 ± 2.18 h/night, P < 0.001) and nasal pillows (3.48 ± 2.20 h/night, P = 0.007). Residual AHI was higher with oronasal masks (7.2 ± 5.2) compared to nasal masks (4.0 ± 4.2, P < 0.001) and nasal pillows (4.1 ± 3.3, P < 0.001). Twenty-two (25.9%) patients had the best adherence with oronasal masks (4.22 ± 2.14 vs 2.93 ± 2.12 h/night, P = 0.016). These patients had lower NOSE scores (15 (0-35) vs 40 (10-55), P = 0.024) and larger menton-labrale inferioris/biocular width ratios (31 ± 3% vs 28 ± 4%, P = 0.019).CONCLUSION:
Nasal masks are the preferred interface during CPAP initiation. Patients with less nasal obstruction and a proportionally increased chin-lower lip distance to mid-face width may have better CPAP adherence with an oronasal mask interface.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Patient Compliance
/
Sleep Apnea, Obstructive
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Continuous Positive Airway Pressure
/
Face
/
Masks
Type of study:
Clinical_trials
/
Etiology_studies
Limits:
Adult
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Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Respirology
Year:
2019
Document type:
Article
Affiliation country: