Sleep Medicine Center, Niguarda Hospital, Milan, Italy.
Respiratory Unit, IRCCS, Ospedale Maggiore Policlinico, Milan, Italy.
Sleep Med. 2018 Jan;41:94-99. doi: 10.1016/j.sleep.2017.08.024. Epub 2017 Oct 12.
Mask-related side effects can negatively influence adherence to continuous positive airway pressure (CPAP). Nasal pillows (P) can be an alternative to the standard nasal masks (N), although there are no data about their long-term efficacy. This study aimed to assess long-term effectiveness and adherence to CPAP therapy delivered with nasal pillows in obstructive sleep apnea syndrome (OSAS) patients.
A retrospective observational design involving a series of consecutive CPAP-naïve patients affected by OSAS. After an initial mask fitting session all patients were allowed to choose the type of nasal interface (N or P) they preferred. Outcomes were assessed 5 days after CPAP titration, and after 2 and 12 months. Patients were offered the option of switching to an alternative mask if needed.
Data from 144 patients were analyzed. Subjects were predominantly male (76%), middle aged (58.14 ± 12.86), moderately obese (body mass index: 33.89 ± 7.56), and affected by severe OSAS (apnea-hypopnea index: 47.60 ± 21.31). A total of 102 patients (70.8%) chose P, and 42 (29.2%) chose N. Clinical and polygraphic features, and CPAP pressure levels were similar in P and N groups, both at baseline and at 12 months. A good adherence to treatment was observed in both groups (P, 5.5 ± 1.8 h; N, 5.3 ± 1.5 h). Seventy-six patients (53%) reported at least one side effect during the whole study period, without statistically significant between-group differences. Nostril pain was the most frequent side effect in P.
Nasal pillows showed equal long-term effectiveness and objective adherence as standard nasal masks.
面罩相关的副作用会对持续气道正压通气（CPAP）的依从性产生负面影响。鼻枕（P）可以作为标准鼻罩（N）的替代品，尽管目前尚无关于其长期疗效的数据。本研究旨在评估在阻塞性睡眠呼吸暂停综合征（OSAS）患者中使用鼻枕进行 CPAP 治疗的长期效果和依从性。
这是一项回顾性观察设计，涉及一系列连续的 CPAP 初治患者，所有患者在初始面罩适配后均允许选择他们喜欢的鼻接口类型（N 或 P）。疗效评估在 CPAP 滴定后 5 天、2 个月和 12 个月时进行。如果需要，患者可以选择更换为其他面罩。
共分析了 144 例患者的数据。受试者主要为男性（76%）、中年（58.14±12.86 岁）、中度肥胖（BMI：33.89±7.56）和患有严重 OSAS（呼吸暂停低通气指数：47.60±21.31）。共有 102 例患者（70.8%）选择 P，42 例（29.2%）选择 N。在基线和 12 个月时，P 组和 N 组的临床和多导睡眠图特征以及 CPAP 压力水平相似。两组患者的治疗依从性均较好（P 组为 5.5±1.8 小时；N 组为 5.3±1.5 小时）。76 例患者（53%）在整个研究期间至少报告了一种副作用，但组间无统计学差异。在 P 组中，鼻痛是最常见的副作用。
鼻枕与标准鼻罩具有同等的长期疗效和客观依从性。
