Hospital IPO, Av. Repuplica Argentina 2069, PR, 80610-010, Curitiba, Brazil.
Unifesp, Sao Paulo, Brazil.
Sleep Breath. 2021 Sep;25(3):1-8. doi: 10.1007/s11325-020-02251-6. Epub 2021 Jan 5.
Nasal masks are usually the first choice for CPAP therapy, but patients may experience side effects. There are limited data regarding the efficacy of nasal pillows masks during CPAP titration. This study aimed to compare the polysomnography outcomes during CPAP titration while comparing two types of masks (nasal and pillows) and to assess whether or not the patient characteristics differed between mask preferences.
In a sleep-disorders clinic, we prospectively analyzed all patients undergoing CPAP titration for three consecutive months. CPAP pressures were manually titrated. Anthropometric data (age, sex, body mass index, and neck and waist circumferences) and OSA severity were documented. Patients completed a self-administered questionnaire that measured nasal obstruction (NOSE scale). Before titration, both types of masks were presented to patients, and each of them chose the one they preferred.
Of 157 patients, 55% (n = 86) used nasal masks, and 45% (n = 71) used nasal pillows masks. There was no difference according to mask type chosen by age, sex, body mass index, neck and waist circumferences, and NOSE scale. Polysomnography outcomes were similar between the mask groups. The mean CPAP level was 9.4 ± 1.8 cm HO for nasal masks and 9.1 ± 2.0 cm HO for nasal pillows (p = 0.61). Residual apnea-hypopnea index was 3.0 ± 2.8 events/h for nasal mask and 3.5 ± 4.1 events/h for pillow mask (p = 0.28). Baseline AHI, body mass index, neck and waist circumferences, and residual AHI were independent predictors of a higher CPAP pressure for both groups (p < 0.0001).
Nasal pillows masks seem to be as effective as nasal masks and may be considered to be an initial choice for CPAP titration.
鼻罩通常是 CPAP 治疗的首选，但患者可能会出现副作用。关于 CPAP 滴定期间鼻枕面罩疗效的数据有限。本研究旨在比较两种面罩（鼻罩和枕罩）在 CPAP 滴定期间的睡眠监测结果，并评估患者对不同类型面罩的偏好是否与患者特征有关。
在睡眠障碍诊所，我们前瞻性分析了连续三个月接受 CPAP 滴定的所有患者。CPAP 压力由手动滴定。记录了人体测量学数据（年龄、性别、体重指数以及颈围和腰围）和 OSA 严重程度。患者完成了一份自我管理问卷，该问卷测量了鼻阻塞（NOSE 量表）。在滴定之前，向患者展示了这两种类型的面罩，他们选择了自己喜欢的那一种。
在 157 名患者中，55%（n=86）使用鼻罩，45%（n=71）使用鼻枕面罩。选择面罩类型与年龄、性别、体重指数、颈围和腰围以及 NOSE 量表无关。两组之间的睡眠监测结果无差异。鼻罩的平均 CPAP 水平为 9.4±1.8cmHO，鼻枕面罩为 9.1±2.0cmHO（p=0.61）。残余呼吸暂停低通气指数（apnea-hypopnea index，AHI）为鼻罩 3.0±2.8 次/小时，枕罩 3.5±4.1 次/小时（p=0.28）。对于两组患者，基线 AHI、体重指数、颈围和腰围以及残余 AHI 是 CPAP 压力较高的独立预测因素（p<0.0001）。
鼻枕面罩似乎与鼻罩一样有效，可作为 CPAP 滴定的初始选择。
