Impact of Mask Type on the Effectiveness of and Adherence to Unattended Home-Based CPAP Titration

Abstract

Objectives. To compare interfaces performance during home-based automatic titration (APAP). Methods. Retrospective study based on APAP titration from Obstructive Sleep Apnea Syndrome (OSA) patients. Results. 707 patients, 513 men (70.6%), were titrated. Masks were 104 pillows (14.7%), group I (GI); 532 nasal (75.2%), group II (GII); and 71 oronasal masks (10%), group III (GIII). We found differences in effective pressure to the device (P90/P95) (GI: 7.13±1.9 vs. GII: 8.3±2.1 vs. GIII: 9.3±2.6 cmH2O, p <0.001) but not in final pressure titrated manually (GI: 7.9±1.4 vs. GII: 8.6±1.6 vs. GIII: 9.2±1.9 cm of H2O, p >0.5), where lower residual AHI for pillows was p <0.001 and leaks for nasal were p <0.001. No differences were found in compliance (hours) (GI: 6.3±1.2 vs. GII: 6.2±1.1 vs. GIII: 6.1±1.0, p <0.4). Conclusion. During auto-adjusting titration by CPAP-naïve patients, nasal masks had lower leak rates and nasal pillows presented a similar performance.

Effect of healthcare benefits on short‐term adherence of positive airway pressure therapy

“…OSA is associated with increased fatigue, somnolence, headaches, depression, and decreased quality of life, as well as higher risks of metabolic disease, cardiovascular disease, and motor vehicle accidents 5,6 . Treatment options for OSA include weight loss, oral appliances, surgical procedures, and positive airway pressure (PAP) therapy, 1,5 among these options, PAP is the treatment of choice for patients with moderate to severe OSA 1,7 …”

“…Multiple factors affect adherence to PAP, including the patients, their families, their physicians, other healthcare professionals, healthcare facilities, and governmental policies; all of these play important roles, in addition to the more commonly emphasized equipment and personality factors 2 . The impact of the severity of this disease cannot be overlooked 9 ; it has been reported that PAP adherence ranges from 40% to 80% 7 . Therefore, achieving good adherence to PAP is a well‐recognized clinical goal for the management of OSA 10 …”

“…procedures, and positive airway pressure (PAP) therapy, 1,5 among these options, PAP is the treatment of choice for patients with moderate to severe OSA. 1,7 Although PAP therapy is highly efficient for controlling OSA, its effectiveness is limited by varying patient adherence. 8 Multiple factors affect adherence to PAP, including the patients, their families, their physicians, other healthcare professionals, healthcare facilities, and governmental policies; all of these play important roles, in addition to the more commonly emphasized equipment and personality factors.…”

“…2 The impact of the severity of this disease cannot be overlooked 9 ; it has been reported that PAP adherence ranges from 40% to 80%. 7 Therefore, achieving good adherence to PAP is a wellrecognized clinical goal for the management of OSA. 10 There are two main healthcare programs for universal coverage in South Korea.…”

Evaluation of CPAP mask performance during 3 years of mask usage: time for reconsideration of renewal policies?

“…Continuous positive airway pressure (CPAP) therapy is the best available treatment for moderate (AHI [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] to severe OSA (AHI >30), and with CPAP treatment the AHI should be normalised. [8][9][10][11][12] CPAP treatment may be administered with a nasal mask, nasal pillows or an oronasal mask.…”