Effects of Heated Humidification and Topical Steroids on Compliance, Nasal Symptoms, and Quality of Life in Patients with Obstructive Sleep Apnea Syndrome Using Nasal Continuous Positive Airway Pressure

Ryan, Suzanne; Doherty, Liam S.; Nolan, Geraldine; McNicholas, Walter T.

doi:10.5664/jcsm.27596

Cited by 67 publications

(48 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similarly, Ryan and colleagues found that humidification, but not fluticasone, decreased the frequency of nasal symptoms in patients on CPAP. In addition, the authors did not observe any improvement in CPAP adherence with fluticasone [37].…”

Section: Chronic Rhinitismentioning

confidence: 78%

CPAP: enhancing its use

Williams

Lettieri

Dombrowsky

2012

Curr Respir Care Rep

View full text Add to dashboard Cite

Despite many advances in the treatment of obstructive sleep apnea with CPAP therapy, adherence remains poor in many patients. To optimize the treatment of OSA, it is crucial to enhance the efficacy and effectiveness of CPAP. Identifying barriers to CPAP use, applying technological advancements, and implementing strategies to maximize both the therapeutic response and rate of adherence are fundamentally important in the care of patients with OSA. We review the current literature and provide personal anecdotes, emphasizing the importance of patient education as well as common troubleshooting strategies, particularly during the initial phase of therapy.

show abstract

Section: Chronic Rhinitismentioning

confidence: 78%

CPAP: enhancing its use

Williams

Lettieri

Dombrowsky

2012

Curr Respir Care Rep

View full text Add to dashboard Cite

show abstract

“…Nasal side-effects are common with CPAP therapy (Kakkar and Berry, 2007;Pepin et al, 1995), and heated humidification or topical nasal steroid sprays are frequently prescribed to treat nasal complaints. Several studies have confirmed the effectiveness of these measures in improving these side-effects (Mador et al, 2005;Massie et al, 1999;Neill et al, 2003;Ryan et al, 2009), with some of them also demonstrating improved compliance (Massie et al, 1999;Neill et al, 2003). We carefully assessed all patients following their autotitration with regards to nasal side-effects, and prescribed heated humidification to those complaining of such symptoms.…”

Section: Discussionmentioning

confidence: 98%

Nasal pillows as an alternative interface in patients with obstructive sleep apnoea syndrome initiating continuous positive airway pressure therapy

Ryan

Garvey

Swan

et al. 2011

Journal of Sleep Research

Self Cite

View full text Add to dashboard Cite

Summary Side‐effects directly due to the nasal mask are common in patients with obstructive sleep apnoea syndrome (OSAS) commencing continuous positive airway pressure (CPAP). Recently, nasal pillows have been designed to overcome these issues. Limited evidence exists of the benefits and effectiveness of these devices. Twenty‐one patients (19 male, 49 ± 10 years) with the established diagnosis of OSAS [apnoea/hypopnoea index (AHI): 52 ± 22] and who had a successful CPAP titration were commenced on CPAP therapy (10 ± 2 cmH2O), and randomized to 4 weeks of a nasal pillow (P) and a standard nasal mask (M) in a crossover design. Outcome measures were objective compliance, AHI, quality of life, Epworth Sleepiness Score (ESS) and CPAP side‐effects. There was no difference in compliance (M versus P: 5.1 ± 1.9 h versus 5.0 ± 1.7 h; P = 0.701) and AHI (2.6 ± 2.7 versus 3.0 ± 2.9; P = 0.509). Quality of life and ESS improved with CPAP, but there was no difference in the extent of improvement between both devices. Usage of nasal pillows resulted in less reported pressure on the face and more subjects found the nasal pillow the more comfortable device. However, there was no clear overall preference for either device at the end of the study (mask = 57%, pillow = 43%; P = 0.513). The applied CPAP pressure did not correlate with compliance, AHI and ESS. Furthermore, no differences in outcome parameters were noted comparing groups with CPAP pressure <10 and ≥10 cm H2O. Nasal pillows are equally effective in CPAP therapy, but do not generally lead to improved compliance.

show abstract

“…26,45 Since 2008, several additional randomized clinical trials have been published, mostly looking at OSA subgroups, not so much in terms of disease severity, but in highly specific patient populations like Alzheimer's patients, 46 stroke patients, 47 and patients with metabolic syndrome 48 rather than those with a particular level of disease severity, varying risk levels for nonadherence, or different anatomical bases for their OSA. Most of these more recent studies fall into many of the traps of prior research, generally being short term, 36,39,40,46,[49][50][51][52] failing to compare different treatment approaches, or using sample sizes inadequate to detect clinically meaningful differences. [52][53][54][55] In one larger and longer randomized trial, in which 723 nonsomnolent patients with OSA were randomized either to CPAP (N 5 357) or no active treatment (N 5 366) over a median of 4 years of follow-up, no intergroup difference was detected in the incidence of hypertension or other cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%