Persistence of Upper-Airway Symptoms During CPAP Compromises Adherence at 1 Year.
BACKGROUND: The most common adverse effects of CPAP are related to the upper airways. We evaluated upper-airway symptoms before and after a CPAP trial as well as their effect on CPAP adherence. We also evaluated the effect of humidification added to CPAP therapy on upper-airway symptoms. METHODS: We...
| Published in: | Respiratory Care Vol. 61; no. 5; pp. 652 - 658 |
|---|---|
| Main Authors: | , , |
| Format: | research tables/charts Journal Article |
| Published: |
Mary Ann Liebert, Inc.
May2016
|
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=115015109&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 115015109 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: May2016 vid: 61 iid: 5 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 115015109 115015109 115015109 10.4187/respcare.04113 115015109 ppf: 652 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Persistence of Upper-Airway Symptoms During CPAP Compromises Adherence at 1 Year. aug: au: Kreivi, Hanna-Riikka Maasilta, Paula Bachour, Adel affil: Department of Pulmonary Medicine, Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland sug: subj: Continuous Positive Airway Pressure Adverse Effects Patient Compliance Evaluation Human Confidence Intervals Questionnaires Adult Middle Age Aged T-Tests Chi Square Test Visual Analog Scaling Prospective Studies Humidity Severity of Illness Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years ab: BACKGROUND: The most common adverse effects of CPAP are related to the upper airways. We evaluated upper-airway symptoms before and after a CPAP trial as well as their effect on CPAP adherence. We also evaluated the effect of humidification added to CPAP therapy on upper-airway symptoms. METHODS: We followed for 1 y 536 subjects with obstructive sleep apnea scheduled consecutively for CPAP initiation. Subjects completed visual analog questionnaires on nasal stuffiness, rhinorrhea, and mouth dryness (0 = no symptoms, 100 = severe symptoms). RESULTS: Before CPAP initiation, mean nasal stuffiness score was 29.6 ± 24.9, rhinorrhea score was 16.0 ± 21.7, and mouth dryness score was 43.8 ± 33.1. In subjects who quit CPAP treatment before the 1-y follow-up, the increase in rhinorrhea score during CPAP initiation was significant, 5.3 (95% CI 0.5-9.5, P = .02), and in those using CPAP at 1 y, nasal stuffiness score and mouth dryness score decreased significantly during initiation, -5.1 (95% CI -7.9 to -2.4, P < .001) and -21.2 (-25.5 to -17.4, P < .001). Mouth dryness score decreased significantly with CPAP regardless of humidification: change with humidification, -18.1 (95% CI -22.1 to -14.3), P < .001; change without, -10.5 (95% CI -16.9 to -4.1), P = .002. Humidification also prevented the aggravation of rhinorrhea (change, -0.4 [95% CI --2.6 to 1.9], P -- .75) and alleviated nasal stuffiness (change --5.3 [95% CI -7.8 to -2.6], P < .001) with CPAP, whereas its absence induced a significant rise in symptom scores: change in rhinorrhea, 11.5 (95% CI 7.1-16.7), P < .001; change in nasal stuffiness, 8.5 (95% CI 3.9-13.5, P < .001). CONCLUSIONS: The severity of upper-airway symptoms before CPAP does not predict CPAP use at 1 y, whereas CPAP non-users at 1 y had smaller or no alleviation in symptom scores during initiation compared with those who continued CPAP treatment. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|