Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China.
Sleep Breath. 2013 Mar;17(1):133-8. doi: 10.1007/s11325-012-0661-y. Epub 2012 Feb 4.
Previous studies have shown that routine heated humidifier (HH) do not provide any benefit during continuous positive airway pressure (CPAP) titration if there are no significant naso-pharyngeal symptoms. In clinical practice, nasal diseases and upper airway symptoms are very common. This study investigates the effects of HH during CPAP titration in subjects with or without naso-pharyngeal symptoms.
Fifty-two patients who received polysomnography with CPAP titration were randomly assigned to HH and non-HH groups. Their nasal cavity, pharynx, and naso-pharynx were evaluated before CPAP titration, and a questionnaire on subjective sensation, including naso-pharyngeal symptoms, willingness to further use CPAP, and sleep improvement, was used. Objective (e.g., leak, apnea-hypopnea index (AHI) reduction, and optimal CPAP pressure level) and subjective data were analyzed between the two groups.
In subjective sensation, the HH group did not have any benefit in further willingness to use CPAP and in sleep improvement, but had improved naso-pharyngeal symptoms (p = 0.043). There were no significant differences in leak, AHI reduction, and optimal CPAP pressure, even in patients with significant naso-pharyngeal symptoms.
Routine use of HH is not necessary during CPAP titration regardless of naso-pharyngeal symptoms.
既往研究表明，如果患者不存在明显的鼻咽部症状，持续气道正压通气（CPAP）滴定过程中常规使用热湿交换器（HH）并无获益。在临床实践中，鼻部疾病和上呼吸道症状非常常见。本研究旨在探讨 CPAP 滴定过程中 HH 对存在或不存在鼻咽部症状患者的影响。
52 例接受 CPAP 滴定多导睡眠图监测的患者被随机分为 HH 组和非 HH 组。在 CPAP 滴定前评估患者的鼻腔、咽部和鼻咽部，并使用包括鼻咽部症状、进一步使用 CPAP 的意愿和睡眠改善在内的主观感觉问卷进行评估。分析两组间的客观（如漏气、呼吸暂停低通气指数（AHI）降低和最佳 CPAP 压力水平）和主观数据。
在主观感觉方面，HH 组在进一步使用 CPAP 的意愿和睡眠改善方面没有获益，但鼻咽部症状有所改善（p=0.043）。即使在存在明显鼻咽部症状的患者中，漏气、AHI 降低和最佳 CPAP 压力也无显著差异。
无论是否存在鼻咽部症状，CPAP 滴定过程中常规使用 HH 并无必要。
