Nasal insufflation treatment adherence in obstructive sleep apnea

Mudiaga O. Sowho, Michael J. Woods, Paolo Biselli, Brian M. McGinley, Luis F. Buenaver, Jason P. Kirkness

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Nasal insufflation (NI) is a novel treatment method that has been introduced for improving respiration during sleep. NI’s warmed and humidified nasal airflow provides ventilatory assistance delivered as a rapidly dispersed pressure head, with minimal side wall pressures, that may affect treatment tolerability. The aim of the current study was to investigate objective and subjective adherence rates for NI therapy in mild to moderate obstructive sleep apnea (OSA). Methods: Ten patients (three men and seven women; age, 51.3 ± 9.6 years; BMI, 32.2 ± 7.7 kg/m2 [mean ± sd]) with recently diagnosed mild to moderate OSA (10.9 ± 5.8 events/h) were investigated. A crossover design was used to compare adherence to NI and continuous positive airway pressure (CPAP) therapy using a range of objective and subjective measurements. Objective (sleep efficiency (%) and arousal indices (arousal/h)) and subjective evaluations of sleep quality were carried out each night in the laboratory. During in-home treatment, adherence for both therapies was assessed objectively (time on therapy) and subjectively (self-reported sleep diary). Results: Objectively derived adherence values were comparable for CPAP and NI, with both treatment devices sharing similar usage per night (3.5 ± 2.5 vs. 3.6 ± 1.6 h/night; respectively) and the number of nights with at least 4 h of treatment (5.5 ± 4.3 vs. 6.8 ± 3.3 nights/trial, respectively). Self-reported adherence was significantly higher than objectively assessed adherence (p < 0.03). Conclusions: This study showed similar adherence to NI and CPAP over a short period of usage. A randomized clinical trial is now essential for determining the comparative effectiveness of NI therapy in relation to treatment with CPAP.

Original languageEnglish (US)
Pages (from-to)351-357
Number of pages7
JournalSleep and Breathing
Volume19
Issue number1
DOIs
StatePublished - Mar 1 2015

Keywords

  • Home therapy
  • Humidification
  • Nasal cannula
  • Randomized crossover design
  • Sleep apnea

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology

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