Sommer J Ulrich, Kraus Marius, Birk Richard, Schultz Johannes D, Hörmann Karl, Stuck Boris A
Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany,
Sleep Breath. 2014 Mar;18(1):85-93. doi: 10.1007/s11325-013-0853-0. Epub 2013 May 9.
Continuous positive airway pressure (CPAP) is the gold standard in the treatment of obstructive sleep apnea (OSA), but its impact on ciliary function is unclear to date. Furthermore, CPAP is associated with numerous side effects related to the nose and upper airway. Humidified CPAP is used to relieve these symptoms, but again, little is known regarding its effect on ciliary function of the nasal respiratory epithelium.
In this prospective, randomized, crossover trial, 31 patients with OSA (AHI >15/h) were randomized to two treatment arms: nasal continuous positive airway pressure (nCPAP) with humidification or nCPAP without humidification for one night in each modality to assess short-term effects of ciliary beat frequency (CBF) and mucus transport time (MTT) and consecutively for 8 weeks in each modality to assess long-term effects in a crossover fashion.
The baseline CBF was 4.8 ± 0.6 Hz, and baseline MTT was 540 ± 221 s. After one night of CPAP with and without humidification, ciliary function increased moderately yet with statistical significance (p <0.05). The short-term groups with and without humidification did not differ statistically significant. Regarding long-term effects of CPAP, a statistically significant increase in ciliary function above the baseline level and above the short-term level was shown without humidification (7.2 ± 0.4 Hz; 402 ± 176 s; p <0.01). The increase above baseline level was even more pronounced with humidification (9.3 ± 0.7 Hz; 313 ± 95 s; p <0.01). There was a statistically significant difference between both groups at long-term assessment with regard to CBF (p <0.01).
Independent of airway humidification, nCPAP has moderate effects on short-term ciliary function of the nasal respiratory epithelium. However, a significant increase in ciliary function-both in terms of an increased CBF and a decreased MTT-was detected after long-term use. The effect was more pronounced when humidification was used during nCPAP.
持续气道正压通气（CPAP）是治疗阻塞性睡眠呼吸暂停（OSA）的金标准，但迄今为止其对纤毛功能的影响尚不清楚。此外，CPAP与许多与鼻子和上呼吸道相关的副作用有关。湿化CPAP用于缓解这些症状，但同样，关于其对鼻呼吸上皮纤毛功能的影响知之甚少。
在这项前瞻性、随机、交叉试验中，31例阻塞性睡眠呼吸暂停患者（呼吸暂停低通气指数>15次/小时）被随机分为两个治疗组：一组接受带湿化的鼻持续气道正压通气（nCPAP），另一组接受不带湿化的nCPAP，每种方式各使用一晚以评估纤毛摆动频率（CBF）和黏液转运时间（MTT）的短期影响，然后每种方式连续使用8周，以交叉方式评估长期影响。
基线CBF为4.8±0.6Hz，基线MTT为540±221秒。在使用和未使用湿化的CPAP治疗一晚后，纤毛功能有适度增加，但具有统计学意义（p<0.05）。使用和未使用湿化的短期组在统计学上无显著差异。关于CPAP的长期影响，未使用湿化时，纤毛功能在基线水平和短期水平之上有统计学显著增加（7.2±0.4Hz；402±176秒；p<0.01）。使用湿化时，高于基线水平的增加更为明显（9.3±0.7Hz；313±95秒；p<0.
