51104
document
Nasal versus oronasal continuous positive airway pressure masks for obstructive sleep apnea : a pilot investigation of pressure requirement , residual disease , and leak . PURPOSE This single-blinded , randomized , controlled pilot study aimed to investigate whether there is a difference between nasal and oronasal masks in therapeutic continuous positive airway pressure ( CPAP ) requirement , residual disease , or leak when treating obstructive sleep apnea ( OSA ) and if differences were related to measures of upper airway size . METHODS Patients with severe OSA currently using CPAP at ≥4 h/night with a nasal mask were examined ( including Mallampati scale , incisal relationship , and mandibular protrusion ) and then randomized to receive auto-positive airway pressure ( PAP ) or fixed CPAP at a manually titrated pressure for 1 week each at home , with immediate crossover . Within each week , a nasal mask and two oronasal masks were to be used for two or three nights each in random order . Data were downloaded from the device . RESULTS Twelve patients completed the trial ( mean ± SD AHI 59.8 ± 28.6 events/h ; CPAP 11.1 ± 3.2 cmH ( 2 ) O ; BMI 37.7 ± 5.0 kg/m ( 2 ) ) . During auto-PAP , the median 95th percentile pressure delivered with all masks was within 0.5 cmH ( 2 ) O ( p > 0.05 ) . During CPAP , median residual AHI was 0.61 ( IQR = 1.18 ) for the nasal mask , 1.70 ( IQR = 4.04 ) for oronasal mask 1 , and 2.48 ( IQR = 3.74 ) for oronasal mask 2 ( p = 0.03 ) . The 95th percentile leak was lowest with the nasal mask during both CPAP and auto-PAP ( both p < 0.01 ) . Differences in pressure or residual disease were not related to measures of upper airway shape or body habitus . CONCLUSIONS In obese OSA patients changing from a nasal to oronasal mask increased leak and residual AHI but did not affect the therapeutic pressure requirement . The findings of the current study highlight mask leak as the major difficulty in the use of oronasal masks .
51105
Intervention_Physical
Nasal versus oronasal continuous positive airway pressure masks
51106
Intervention_Physical
nasal and oronasal masks
51107
Participant_Condition
obstructive sleep apnea :
51108
Participant_Condition
obstructive sleep apnea ( OSA )
51109
Participant_Sample-size
Twelve