CPAP therapy: Which interface is most preferred by OSA patients?
A recent study has found that patients with obstructive sleep apnoea (OSA) prefer nasal masks during continuous positive airway pressure (CPAP) initiation.
On the other hand, “[p]atients with less nasal obstruction and a proportionally increased chin‐lower lip distance to mid‐face width may have better CPAP adherence with an oronasal mask interface,” the authors said.
A total of 85 patients (mean age, 46±12 years; body mass index, 29.9±5.6 kg/m2; apnoea–hypopnoea index [AHI], 53.6±24.0 events/h) participated in the study.
Among OSA patients, there was better adherence with nasal masks (average night use, 3.96±2.26 h/night) compared to oronasal masks (3.26±2.18 h/night; p<0.001) and nasal pillows (3.48±2.20 h/night; p=0.007). Oronasal masks (7.2±5.2) had higher residual AHI than nasal masks (4.0±4.2; p<0.001) and nasal pillows (4.1±3.3; p<0.001).
Of the patients, 22 (25.9 percent) had the best adherence with oronasal masks (4.22±2.14 vs 2.93±2.12 h/night; p=0.016). They had lower Nasal Obstruction Symptom Evaluation (NOSE) scores (15 vs 40; p=0.024) and larger menton-labrale inferioris/biocular width ratio (31±3 percent vs 28±4 percent; p=0.019).
The authors conducted a randomized crossover trial of mask interfaces in CPAP therapy for moderate-to-severe OSA to assess adherence and efficacy of CPAP therapy with nasal mask, nasal pillow and oronasal masks. In addition, they analysed demographic data, NOSE scores and craniofacial measurements for associations with adherence with oronasal masks.
“A major challenge with the treatment of OSA is adherence to CPAP therapy. Mask tolerability is an important determinant of adherence, [but] evidence to guide selection of mask interfaces is lacking,” the authors noted.