Clinical side effects of continuous positive airway pressure in patients with obstructive sleep apnoea

Ghadiri, Maliheh; Grunstein, Ron

doi:10.1111/resp.13808

Cited by 28 publications

(16 citation statements)

References 103 publications

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“…Side effects of CPAP commonly include congestion, dry mouth, and adverse effects from the face mask itself including skin irritation and sores. Air leaks, noise complaints, and general mask discomfort are other reported side effects that may contribute to treatment failure and lack of adherence to CPAP therapy [18].…”

Section: Discussionmentioning

confidence: 99%

Continuous Positive Airway Pressure vs Mandibular Advancement Devices in the Treatment of Obstructive Sleep Apnea: An Updated Systematic Review and Meta-Analysis

Pattipati¹,

Gudavalli²,

Zin³

et al. 2022

Cureus

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Introduction: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder which has various treatment options, however, continuous positive airway pressure (CPAP) remains the gold standard. The aim of this meta-analysis is to compare the current first-line treatment of OSA, i.e., the continuous positive airway pressure (CPAP) with mandibular advancement devices (MADs) in mild to severe OSA.Objective: This meta-analysis is a comparison of the efficacy of continuous positive airway pressure vs mandibular advancement devices in patients with mild to severe obstructive sleep apnea. The primary objective of the meta-analysis is to compare the efficacy of CPAP vs MADs in the treatment of OSA. This meta-analysis includes randomized control and cross-over studies that compare the efficacy of CPAP and MAD and outcomes are reported in terms of apnea-hypopnea index (AHI), lowest oxygen saturation, and Epworth sleepiness scale both pre-and post-treatment.Data sources and study selection: A PubMed and Cochrane database search was conducted in May 2021 and study bibliographies were reviewed. Randomized clinical trials comparing the effect of CPAP and MAD on AHI, lowest oxygen saturation, and ESS in patients with obstructive sleep apnea were selected. Of the 436 studies initially identified, eight were selected for analysis after screening. The quantitative measures used for comparing the efficacy of CPAP and MAD were post-treatment apnea-hypopnea index (AHI), lowest oxygen saturation, and post-treatment Epworth score scale (ESS).Data extraction and synthesis: A network of meta-analyses was performed using RevMan (Copenhagen, Denmark: Nordic Cochrane Center) where multivariate random-effects models were used to generate pooled estimates. Data were analyzed using generic inverse variance method and P < 0.05 is regarded as statistically significant. Combined summary statistics of standardized (STD) paired difference in mean for individual studies and combined studies was calculated. A chi-square-based test of homogeneity was performed and the inconsistency index (I 2 ) statistic was determined.Results: Compared the AHI, lowest oxygen saturation, and ESS from baseline to follow-up pre-and posttreatment in both CPAP and MAD groups; after the database search 436 records were identified, eight studies were included in the RCT, and three were RCT crossover studies. The duration of treatment varies in each group. AHI, ESS, and lowest oxygen saturation are calculated pre-and post-treatment. Compared with MAD, CPAP was associated with decrease in AHI with a mean difference of -5.83 (95% CI, -8.85, -2.81, P < 0.01). The lowest oxygen saturation was also decreased in CPAP group compared to MAD group with a mean difference of 0.72 (95% CI, 0.51, 0.94, P < 0.01). However, there was no statistically significant difference in ESS between CPAP and MAD group with a mean difference of 0.23 (95% CI, -0.24, 0.70, P = 0.34). The metaanalysis states that among patients with obstructive sleep apnea, both CPAP and MADs are effecti...

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Section: Discussionmentioning

confidence: 99%

Continuous Positive Airway Pressure vs Mandibular Advancement Devices in the Treatment of Obstructive Sleep Apnea: An Updated Systematic Review and Meta-Analysis

Pattipati¹,

Gudavalli²,

Zin³

et al. 2022

Cureus

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“…Further, side effects of CPAP may influence adherence, like mucosal drying, difficult nasal breathing, claustrophobia, etc. ( 24 , 25 ). Additionally, patients’ psychosocial factors such as the internal locus of control ( 26 ), mental health, personality ( 27 – 29 ), and availability of social support ( 30 ) can affect adherence.…”

Section: Factors Associated With Continuous Positive Airway Pressure ...mentioning

confidence: 99%

“…Medical cost, insufficient time, and transport issues concerning patients reduce CPAP adherence. Thus, CPAP adherence is determined by multifactor and should be individualized and closely monitored to address non-compliance and tolerance when prescribed ( 12 , 25 ).…”

Section: Factors Associated With Continuous Positive Airway Pressure ...mentioning

confidence: 99%

Telehealth Technology Application in Enhancing Continuous Positive Airway Pressure Adherence in Obstructive Sleep Apnea Patients: A Review of Current Evidence

et al. 2022

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Obstructive sleep apnea (OSA) is a common type of sleep-disordered breathing associated with multiple comorbidities. Continuous positive airway pressure (CPAP) is the first choice for moderate-severe OSA but poor compliance brings a great challenge to its effectiveness. Telehealth interventions ease the follow-up process and allow healthcare facilities to provide consistent care. Fifth-generation wireless transmission technology has also greatly rationalized the wide use of telemedicine. Herein, we review the efficacy of the telehealth system in enhancing CPAP adherence. We recommend applying telemonitoring in clinical practice and advocate the development of a biopsychosocial telemedicine model with the integration of several interventions. Big databases and promising artificial intelligent technologies make clinical decision support systems and predictive models based on these databases possible.

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“…Addressing possible side effects of PAP early and effectively can also help improve adherence among pediatric patients. Skin irritation, specifically contact dermatitis, rash, redness, and even ulceration can all occur from use of the PAP mask and can be avoided/treated with careful monitoring and/or barrier interventions, topical treatments, or by alternating masks to allow skin time without contact [62,63]. Moreover, ensuring the mask is gently resting on the face (not tightly strapped down) is important to minimize pressure on both the skin and midface.…”

Section: Positive Airway Pressure Adherencementioning

confidence: 99%

“…Other side effects can include aerophagia (swallowing of air into the stomach) that can cause bloating and discomfort. Treatment or avoidance of aerophagia can include reducing the pressure level or transitioning from CPAP to bilevel PAP [62,64].…”

Section: Positive Airway Pressure Adherencementioning

confidence: 99%

Positive Airway Pressure Therapy for Pediatric Obstructive Sleep Apnea

Hady

Okorie

2021

Children

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Pediatric obstructive sleep apnea syndrome (OSAS) is a disorder of breathing during sleep, characterized by intermittent or prolonged upper airway obstruction that can disrupt normal ventilation and/or sleep patterns. It can affect an estimated 2–4% of children worldwide. Untreated OSAS can have far reaching consequences on a child’s health, including low mood and concentration as well as metabolic derangements and pulmonary vascular disease. Most children are treated with surgical intervention (e.g., first-line therapy, adenotonsillectomy); however, for those for whom surgery is not indicated or desired, or for those with postoperative residual OSAS, positive airway pressure (PAP) therapy is often employed. PAP therapy can be used to relieve upper airway obstruction as well as aid in ventilation. PAP therapy is effective in treatment of OSAS in children and adults, although with pediatric patients, additional considerations and limitations exist. Active management and care for various considerations important to pediatric patients with OSAS can allow PAP to be an effective and safe therapy in this population.

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Clinical side effects of continuous positive airway pressure in patients with obstructive sleep apnoea

Cited by 28 publications

References 103 publications

Continuous Positive Airway Pressure vs Mandibular Advancement Devices in the Treatment of Obstructive Sleep Apnea: An Updated Systematic Review and Meta-Analysis

Continuous Positive Airway Pressure vs Mandibular Advancement Devices in the Treatment of Obstructive Sleep Apnea: An Updated Systematic Review and Meta-Analysis

Telehealth Technology Application in Enhancing Continuous Positive Airway Pressure Adherence in Obstructive Sleep Apnea Patients: A Review of Current Evidence

Positive Airway Pressure Therapy for Pediatric Obstructive Sleep Apnea

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