Nasal Breathing and Continuous Positive Airway Pressure (CPAP) in Patients with Obstructive Sleep Apnea (OSA)

Hollandt, J. H.; Mahlerwein, M.

doi:10.1007/s11325-003-0087-7

Cited by 27 publications

(16 citation statements)

References 39 publications

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“…Compliance with CPAP therapy has been reported to range from 46.6 to 86% [26][27][28][29][30], and thus, compliance with CPAP, which was not evaluated in the present study, may have affected our results. Actually, 4 of the 6 patients (66.7%) that refused CPAP developed atelectasis.…”

Section: Discussionmentioning

confidence: 78%

Continuous Positive Airway Pressure Therapy Can Prevent Pulmonary Atelectasis after Laparoscopic Roux-en-Y Gastric Bypass Surgery in Obese Patients

Ahn

Bae

Suh

et al. 2019

J Metab Bariatr Surg

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Purpose: To compare the prophylactic effects of postoperative continuous positive airway pressure (CPAP) therapy plus conventional postoperatively pulmonary physiotherapy (CPP) and postoperative CPP alone on the development of pulmonary atelectasis after laparoscopic Roux-en-Y gastric bypass (LGBP) in obese patients. Materials and Methods: Patients with BMIs＞27.5 kg/m 2 aged between 20 and 65 years were enrolled in the present study. All subjects received LGBP and were divided into 2 groups. Patients in the CPAP group received both CPAP and CPP therapy postoperatively, and patients in the conventional group received CPP alone. The primary outcome was the incidence of postoperative pulmonary atelectasis as determined by chest X-ray after LGBP, and the secondary outcome was duration of postoperative hospital stay (HS). Results: Seventy-three patients were enrolled in this study. Fifty-seven patients received CPAP plus CPP, and 16 patients received CPP. The CPAP group had an atelectasis incidence of 40.4% (23/57) and the conventional group an incidence of 62.5% (10/16). Multivariate analysis showed the incidence of atelectasis after LGBP was significantly lower in the CPAP group (OR 0.198, 95% CI 0.045-0.874; P=0.033) and that HS was significantly correlated with the developments of atelectasis, pneumonia, and complications (partial correlation coefficients 0.271, 0.444 and 0.382; P-values 0.025, ＜0.05 and ＜0.05, respectively). Conclusion: Patients that received continuous positive airway pressure therapy plus conventional pulmonary physiotherapy postoperatively were at significantly less risk of developing pulmonary atelectasis after LGBP than patients that received conventional pulmonary physiotherapy postoperatively.

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Section: Discussionmentioning

confidence: 78%

Continuous Positive Airway Pressure Therapy Can Prevent Pulmonary Atelectasis after Laparoscopic Roux-en-Y Gastric Bypass Surgery in Obese Patients

Ahn

Bae

Suh

et al. 2019

J Metab Bariatr Surg

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“…However, any correlation between the PAP level and PAP compliance has not been clearly identified. Several studies on PAP therapy have not found any correlation between these two parameters (14-17). …”

Section: Discussionmentioning

confidence: 90%

Initial Adherence to Autotitrating Positive Airway Pressure Therapy: Influence of Upper Airway Narrowing

Dhong

Kim

et al. 2009

Clin Exp Otorhinolaryngol

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ObjectivesThere is still debate concerning the reason for the high initial failure rate of positive airway pressure (PAP) treatment. The objective of this study is to investigate the factors of the initial adherence to PAP, with an emphasis on the role of upper airway narrowing.MethodsThe patients were divided into two groups according to the continuation of therapy within the first three months of treatment. The demographic and polysomnographic findings, the minimal nasal cross sectional area (MCA), the degree of palatine tonsilar hypertrophy (PTH) and the modified Mallampati grade of the oropharynx inlet (Orophx) were compared between the study groups.ResultsAmong 36 patients, 23 continued the auto-adjusting positive airway pressure (APAP) therapy (the adherent group) and 13 discontinued APAP within three months (the non-adherent group). The apnea-hypopnea index (AHI) was significantly higher in the adherent group than in the non-adherent group (P<0.001). The AHI distributions of the two groups are extremely different. Thirteen of the 23 patients in the adherent group had an AHI of more than 60/hr, while none of the patients in the non-adherent group had an AHI of more than 60/hr. In the patients with an AHI from 15 to 60/hr, the MCA at the wide side of the nasal cavity and the sum of the MCAs of both sides were significantly larger in the adherent group than those values in the non-adherent group (P=0.004). The PTH and the Orophx were not significantly different between the two groups.ConclusionAHI is a definite significant factor of adherence to APAP therapy. The dimension of the nasal cavity has an influence on initial APAP adherence in the patients who have a not too high level of AHI.

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“…22 In a study from UK, 77% were still using CPAP at three years and median use of CPAP those continuing therapy was 5.3 hours/night. 23 In another UK-based study of over 1000 OSA patients, 4.5% patients refused CPAP treatment (these were more often female and current smokers) and during follow-up 20% stopped treatment, primarily because of a perceived lack of benefit. Methods of survival analysis showed that 68% of patients continued treatment at 5 year.…”

Section: Rates Of Compliancementioning

confidence: 99%

CPAP compliance in patients with moderate to severe obstructive sleep apnea from three centers in South India

Ninan

Balachandran

2017

Int J Res Med Sci

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Background: Obstructive sleep apnea syndrome (OSAS) is a common sleep related breathing disorder, characterised by frequent interruptions of breathing during sleep resulting in arousals and a sympathetic overdrive. The most effective treatment for patients with significant sleep apnea has been a device which delivers positive pressure on the upper airway to act as a physiological splint thus preventing collapse of the upper airway (CPAP) to be used while sleeping. However patient compliance with CPAP use has always been a problem area. Many studies published show a compliance rate between 30% to 80% from different parts of the globe. We wanted to assess compliance with CPAP in our patient population.Methods: A retrospective telephonic interview of patients who had been diagnosed with moderate to severe OSAS from 3 centers in Kerala.Results: In present study we found a net compliance rate of only 14.7% and the primary reason for this high rate of non-compliance was the relatively high cost of the CPAP.Conclusions: The compliance with CPAP in our study was very low and the most cited reason was the cost of the device. In patients who brought the device the compliance rate was similar to studies from western countries. To increase compliance with CPAP in patients with OSAS may require innovative thinking to reduce the upfront cost of the device (e.g. renting or leasing devices, providing options for paying in instalments and also more importantly focussing on low cost devices (CPAP).

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Nasal Breathing and Continuous Positive Airway Pressure (CPAP) in Patients with Obstructive Sleep Apnea (OSA)

Cited by 27 publications

References 39 publications

Continuous Positive Airway Pressure Therapy Can Prevent Pulmonary Atelectasis after Laparoscopic Roux-en-Y Gastric Bypass Surgery in Obese Patients

Continuous Positive Airway Pressure Therapy Can Prevent Pulmonary Atelectasis after Laparoscopic Roux-en-Y Gastric Bypass Surgery in Obese Patients

Initial Adherence to Autotitrating Positive Airway Pressure Therapy: Influence of Upper Airway Narrowing

CPAP compliance in patients with moderate to severe obstructive sleep apnea from three centers in South India

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