Nasal breathing and continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA)

被引：20
作者：
Jan H. Hollandt
Malte Mahlerwein
机构：
[1] Klinik Hals Nasen Ohrenheilkunde, Univ. Klin. Schleswig-Holstein, Lübeck, Campus Lubeck
来源：
Sleep and Breathing | 2003年 / 7卷 / 2期
关键词：
Continuous positive airway pressure; Nasal resistance; Side effects; Sleep apnea;
D O I：
10.1007/s11325-003-0087-7
中图分类号：
学科分类号：
摘要：
Although nasal continuous positive airway pressure (nCPAP) treatment is the most efficient therapy for obstructive sleep apnea (OSA), compliance with therapy is poor because of several side effects. Among these adverse effects some are related to the reactions of the nose to nCPAP which are briefly described. In a long-term survey of 109 OSA patients, 80.6% continued nCPAP for at least 3 years until the last follow-up. Follow-up ranged between 0.8 and 109 months with a mean time of 43 (SD ± 24.7) months. Among all patients treated with nCPAP, only 46.6% met our criteria for long-term compliance, defined as a mean use of the CPAP machine for at least 5 hours per night. Within the objective measures such as age, body mass index, neck circumference, nasal airflow, apnea-hypopnea index, minimal oxygen saturation, and level of nCPAP pressure, no predictive factor for daily use of nCPAP could be found. However, pretherapeutic daytime somnolence (measured by visual analogue scale and Epworth Sleepiness Scale) and its improvement obtained from the therapy showed a significant effect on the daily use of the CPAP machine.
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页码：87 / 93
页数：6
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共 45 条
  • [1] Sullivan C.E., Berthon-Jones M., Issa F.G., Evers L., Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares, Lancet, 1, pp. 862-865, (1981)
  • [2] Jenkinson C., Davies R.J.O., Stradling J.R., Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnea: A randomized prospective parallel trial, Lancet, 353, pp. 2100-2105, (1999)
  • [3] Ballester E., Badia J.R., Hernandez L., Et al., Evidence of effectiveness of continuous positive airway pressure in the treatment of sleep apnea/hypopnea syndrome, Am. J. Respir. Crit. Care Med., 159, pp. 495-501, (1999)
  • [4] Brandenburg U., Weiner M., Becker J., Et al., Haemodynamics and sleep structure in the discontinued nCPAP test in obstructive sleep apnoea syndrome, Pneumologie, 47, pp. 181-183, (1993)
  • [5] Krieger J., Weitzenblum E., Monassier J.P., Stoeckel C., Kurtz D., Dangerous hypoxemia during continuous positive airway pressure treatment of obstructive sleep apnea, Lancet, 2, pp. 1429-1430, (1983)
  • [6] Anderson A.P., Alving J., Lildholdt T., Wulff C., Obstructive sleep apnea initiated by a lax epiglottis: A contraindication for continuous positive airway pressure, Chest, 91, pp. 621-623, (1987)
  • [7] Pepin J.L., Leger P., Veale D., Et al., Side effects of nasal continuous positive airway pressure in sleep apnea syndrome. Study of 193 patients in two French sleep centers, Chest, 107, pp. 375-381, (1995)
  • [8] Strumpf D.A., Harrop P., Dobbin J., Millman R.P., Massive epistaxis from nasal CPAP therapy, Chest, 95, (1989)
  • [9] Jarjour N.N., Wilson P., Pneumocephalus associated with nasal continuous positive airway pressure in a patient with sleep apnea syndrome, Chest, 96, pp. 1425-1426, (1989)
  • [10] Bamford C.R., Quan S.F., Bacterial meningitis - A possible complication of nasal continuous positive airway pressure therapy in a patient with obstructive sleep apnea syndrome and a mucocele, Sleep, 16, pp. 31-32, (1993)
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