BaHammam Ahmed S, Singh Tripat, George Smitha, Acosta Karen Lorraine, Barataman Kashmira, Gacuan Divinagracia E
The University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, Box 225503, Riyadh, 11324, Saudi Arabia.
Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia.
Sleep Breath. 2017 Sep;21(3):569-575. doi: 10.1007/s11325-017-1490-9. Epub 2017 Mar 29.
Positive airway pressure (PAP) is the standard and most effective treatment for obstructive sleep apnea (OSA). It provides a continuous stream of air under positive pressure through the nose, mouth, or both, which prevents collapse of the upper airway. This allows the patient to breathe freely during sleep. The success of PAP therapy depends largely on the selection of the proper interface (mask). The choice and application of the interface in patients with OSA is a great challenge that greatly affects the long-term compliance to PAP therapy.
This article discusses the different types of masks that can be used in patients with OSA, including the differences between nasal, oro-nasal, and total face masks, breathing during wakefulness and sleep, and the impact of interface type on upper airway patency and mask fitting. We also discuss the steps to be considered in choosing the proper interface and potential problems that may arise during long-term use.
Current evidence suggests that the nasal mask is better tolerated, requires lower pressure to eliminate obstructive respiratory events, and is associated with a better sleep quality and better PAP therapy compliance. Nevertheless, the best mask is the one that patient will wear.
气道正压通气（PAP）是阻塞性睡眠呼吸暂停（OSA）的标准且最有效的治疗方法。它通过鼻子、嘴巴或两者提供持续的正压气流，防止上呼吸道塌陷。这使患者在睡眠期间能够自由呼吸。PAP治疗的成功很大程度上取决于合适的接口（面罩）的选择。OSA患者中接口的选择和应用是一项巨大挑战，这极大地影响了对PAP治疗的长期依从性。
本文讨论了可用于OSA患者的不同类型面罩，包括鼻面罩、口鼻面罩和全面罩之间的差异、清醒和睡眠期间的呼吸，以及接口类型对上呼吸道通畅性和面罩适配性的影响。我们还讨论了选择合适接口时应考虑的步骤以及长期使用期间可能出现的潜在问题。
目前的证据表明，鼻面罩耐受性更好，消除阻塞性呼吸事件所需压力更低，并且与更好的睡眠质量和更好的PAP治疗依从性相关。然而，最好的面罩是患者会佩戴的面罩。
