A heated humidifier reduces upper airway dryness during continuous positive airway pressure therapy

Abstract

Upper airway dryness is a frequent side-effect of nasal continuous positive airway pressure (nCPAP) therapy in obstructive sleep apnoea (OSA). In this situation, heated humidification is often used. Alternatively, oily nose drops are frequently applied to relieve dryness. The present study aimed to investigate the efficacy of a heated humidifier in comparison with oily nose drops. Twenty-four OSA patients complaining of serious nCPAP-related upper airway dryness were randomized to 6 weeks of treatment either with heated humidification (HC 100, Fischer & Paykel, Inc., Auckland, New Zealand) or oily nose drops (Colda-Stop, Desitin, Inc., Germany). The patients completed questionnaires on the degree and frequency of upper airway dryness, compliance with nCPAP, intention to terminate nCPAP and comfort during the nCPAP therapy. All 12 patients treated with heated humidification improved in terms of the degree and frequency of upper airway dryness, and reported greater comfort when using the nCPAP device. All patients in the heated humidification group intending to terminate nCPAP therapy because of upper airway dryness persisted with nCPAP on addition of humidification. In contrast, only five out of 12 patients (42%) in the oily nose drops group reported their degree of upper airway dryness to be improved (P = 0.003), only three patients (25%) reported an improvement in the frequency of upper airway dryness (P < 0.001), and only five patients (42%) reported greater comfort when using the nCPAP device with oily nose drops (P < 0.001). In the group using oily nose drops none of the three patients who intended to terminate nCPAP therapy persisted with nCPAP. Heated humidification is highly effective and superior to oily nose drops in reducing the symptoms of upper airway dryness during nCPAP.

Use of heated humidification during nasal CPAP titration in obstructive sleep apnoea syndrome

“…This is in agreement with the only other randomised controlled study, which has examined the effects of heated humidification administered at the time of nCPAP initiation [21]. Contrary to these observations, the application of heated humidification in patients selected for chronic nasal/ oral symptoms has been shown to improve nasal symptoms, patient comfort and compliance [12,22,23]. Even among unselected groups of patients, such as those included in the current study, heated humidification given over a longer duration (o3 weeks) has been reported to reduce the incidence and severity of nasopharyngeal symptoms [13,14,24,25].…”

“…Adverse symptoms of the upper airway are commonly reported with nCPAP [10,11], which can be alleviated with the regular use of heated humidification [12][13][14]. Under experimental conditions, the administration of nCPAP in the presence of mouth leaks leads to the appearance of nasopharyngeal symptoms and a rise in nasal airway resistance (NAR).…”

Hygrometric Properties of Inspired Gas and Oral Dryness in Patients With Acute Respiratory Failure During Noninvasive Ventilation

“…8 For patients with obstructive sleep apnea, HH ameliorates nasal congestion and mouth dryness, and improves satisfaction. 9,10 The humidification performance of HHs, however, varies according to minute ventilation, F IO 2 , and gas leak around the interface. 11 High ambient temperature and high temperature of the ventilator output also reduce HH performance.…”

Humidified nasal continuous positive airway pressure in obstructive sleep apnoea

“…Heated humidification of inspired air attenuates the increase in mucosal blood flow and nasal resistance under experimental conditions [12,13] and adverse upper airway symptoms in OSAS patients chronically treated with nCPAP [9,15,16]. In a recent crossover study, MASSIE et al…”

“…Heated humidification of inspired air attenuates the increase in mucosal blood flow and nasal resistance under experimental conditions [12,13] and adverse upper airway symptoms in OSAS patients chronically treated with nCPAP [9,15,16]. In a recent crossover study, MASSIE et al [15] demonstrated a small but significant improvement in CPAP use with heated humidified nCPAP (nCPAP-humid) compared to a 2-week washout period but no difference compared to CPAP with a cold passover humidifier [15].…”