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This study was undertaken to determine the efficacy of nasal mask (NM) versus full face mask (FFM) for the delivery of noninvasive ventilation (NIV) in subjects with nocturnal hypoventilation.A total of 16 patients (11 males) were enrolled, all with nocturnal hypoventilation currently treated at home with NIV via pressure preset devices. Subjects underwent full polysomnography on three occasions; on the first night current therapy on NM was reviewed, followed by two experimental studies in randomised order using either NM or FFM. NIV settings and oxygen flow rate were the same under both conditions. Notably, 14 of the 16 subjects required the use of a chinstrap to minimise oral leak.Apnoea-hypopnoea indices were within normal limits under both conditions (1.7¡3.4 NM versus 1.6¡2.4 h FFM). The type of interface did not significantly affect gas exchange during sleep (minimum average arterial oxyhaemoglobin saturation total sleep time 93.4¡2.1 NM versus 92.8¡2.5% FFM, Delta transcutaneous carbon dioxide nonrapid eye movement sleep to rapid eye movement sleep (0.58¡0.36 NM versus 0.50¡0.40 kPa FFM). Sleep efficiency was significantly reduced on the FFM (78¡9 NM versus 70¡14% FFM), although arousal indices were comparable under both conditions (15.6¡9.8 NM versus 15.8¡8.8 h FFM).Full face masks appear to be as effective as nasal masks in the delivery of noninvasive ventilation to patients with nocturnal hypoventilation. However, a chinstrap was required to reduce oral leak in the majority of subjects using the nasal mask.

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Background and objective No published studies have examined the long‐term effects of non‐invasive ventilation (NIV) in cystic fibrosis (CF). Our primary aim was to determine if adults with CF and sleep desaturation were less likely to develop hypercapnia with NIV ± O2 compared to low‐flow oxygen therapy (LFO2) or meet the criteria for failure of therapy over 12 months. We studied event‐free survival, hospitalizations, lung function, arterial blood gases (ABG), sleep quality and health‐related quality of life. Methods A prospective, randomized, parallel group study in adult patients with CF and sleep desaturation was conducted, comparing 12 months of NIV ± O2 to LFO2. Event‐free survival was defined as participants without events. Events included: failure of therapy with PaCO2 > 60 mm Hg, or increase in PaCO2 > 10 mm Hg from baseline, increases in TcCO2 > 10 mm Hg, lung transplantation or death. Outcomes were measured at baseline, 3, 6 and 12 months, including lung function, ABG, Pittsburgh Sleep Quality Inventory (PSQI), SF36 and hospitalizations. Results A total of 29 patients were randomized to NIV ± O2 (n = 14) or LFO2 (n = 15) therapy for 12 months. Of the 29 patients, 18 met the criteria for event‐free survival over 12 months. NIV ± O2 group had 33% (95% CI: 5–58%) and 46% (95% CI: 10–68%) more event‐free survival at 3 and 12 months than LFO2 group. No statistically significant differences were seen in spirometry, ABG, questionnaires or hospitalizations. Conclusion NIV ± O2 during sleep increases event‐free survival over 12 months in adults with CF. Further studies are required to determine which subgroups benefit the most from NIV.

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