Nasal obstruction and male gender contribute to the persistence of mouth opening during sleep in <scp>CPAP</scp>‐treated obstructive sleep apnoea

Lebret, Marius; Arnol, Nathalie; Contal, Olivier; Martinot, Jean-Benoît; Tamisier, Renaud; Pépin, Jean‐Louis; Borel, Jean‐Christian

doi:10.1111/resp.12584

Cited by 32 publications

(18 citation statements)

References 36 publications

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“…Mouth opening and oral air leak are potential adverse effects of CPAP, especially in patients with nasal obstruction ( 9 ). In a study that objectively detected nasal and oral breathing, patients with oral breathing were less adherent to nasal CPAP ( 10 ).…”

Section: Resultsmentioning

confidence: 99%

The Importance of Mask Selection on Continuous Positive Airway Pressure Outcomes for Obstructive Sleep Apnea. An Official American Thoracic Society Workshop Report

Genta¹,

Kamińska²,

Edwards³

et al. 2020

Annals ATS

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Continuous positive airway pressure (CPAP) remains the major treatment option for obstructive sleep apnea (OSA). The American Thoracic Society organized a workshop to discuss the importance of mask selection for OSA treatment with CPAP. In this workshop report, we summarize available evidence about the breathing route during nasal and oronasal CPAP and the importance of nasal symptoms for CPAP outcomes. We explore the mechanisms of air leaks during CPAP treatment and possible alternatives for leak control. The impact of nasal and oronasal CPAP on adherence, residual apnea–hypopnea index, unintentional leaks, and pressure requirements are also compared. Finally, recommendations for patient and partner involvement in mask selection are presented, and future directions to promote personalized mask selection are discussed.

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Section: Resultsmentioning

confidence: 99%

The Importance of Mask Selection on Continuous Positive Airway Pressure Outcomes for Obstructive Sleep Apnea. An Official American Thoracic Society Workshop Report

Genta¹,

Kamińska²,

Edwards³

et al. 2020

Annals ATS

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“…This interesting result is likely due to the higher level of nasal resistance caused by the increase in inflammatory response with tobacco consumption [27, 28]. This is a key factor in the persistence of mouth opening and mouth breathing under CPAP [29, 30], favoring mouth leak. It could be hypothesized that smokers were therefore more likely to be fitted with an oronasal mask, which may explain why this variable was no longer significant in the multivariate analysis (confounding factor).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Auto- and Fixed-Continuous Positive Airway Pressure on Air Leak in Patients with Obstructive Sleep Apnea: Data from a Randomized Controlled Trial

Lebret

Rotty

Argento

et al. 2019

Canadian Respiratory Journal

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Auto-CPAP may cause sleep fragmentation due to variations in pressure and unintentional leaks. The aim of this study was to compare air leak between fixed-CPAP and auto-CPAP after 4 months of CPAP treatment. This study is an ancillary analysis of a randomized, double-blind, parallel, controlled trial over 4 months, comparing fixed- and auto-CPAP in newly diagnosed patients with OSA. The following data were extracted from the CPAP devices: mean and 90th percentile pressure, residual apnea-hypopnea index, mean CPAP use, and amount of leak. Within each arm, patients were also randomly allocated to use of one of the three different brands of devices. Since the leak was reported differently for each device, median leak value was determined for each brand and leaks were classified as “above the median” or “below the median”. Data from 269 patients were analyzed. The univariate analysis showed that tobacco consumption, CPAP level, and oronasal masks were associated with leaks above the median value but not the type of CPAP. The multivariate analysis showed that only CPAP level and oronasal masks were associated with leaks below the median. There were no differences in the types of mask used between fixed- and auto-CPAP. There was no impact of the type of CPAP on leaks or the type of interface used. We used a method based on the median leak value to standardize comparisons across devices which report leaks with different definitions.

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“…Oronasal masks might be helpful for sleep‐related mouth leaks or nasal obstruction . Nasal obstruction is associated with mouth opening during sleep as well as poorer adherence to CPAP therapy, and can be subjectively quantified by the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire (Fig. S1, Supplementary Information) .…”

Section: Introductionmentioning

confidence: 99%

Choosing the right mask for your Asian patient with sleep apnoea: A randomized, crossover trial of CPAP interfaces

et al. 2018

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Nasal obstruction and male gender contribute to the persistence of mouth opening during sleep in CPAP‐treated obstructive sleep apnoea

Abstract: ABSTRACT

Cited by 32 publications

References 36 publications

The Importance of Mask Selection on Continuous Positive Airway Pressure Outcomes for Obstructive Sleep Apnea. An Official American Thoracic Society Workshop Report

The Importance of Mask Selection on Continuous Positive Airway Pressure Outcomes for Obstructive Sleep Apnea. An Official American Thoracic Society Workshop Report

Comparison of Auto- and Fixed-Continuous Positive Airway Pressure on Air Leak in Patients with Obstructive Sleep Apnea: Data from a Randomized Controlled Trial

Choosing the right mask for your Asian patient with sleep apnoea: A randomized, crossover trial of CPAP interfaces

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