A convenient expiratory positive airway pressure nasal device for the treatment of sleep apnea in patients non-adherent with continuous positive airway pressure

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• 作者：James K. Walsh^a ; ^b ; ^{james.walsh@stlukes-stl.com} ; Kara S. Griffin^a ; Elizabeth H. Forst^a ; Hasanali H. Ahmed^a ; Rhody D. Eisenstein^a ; Denise Troy Curry^a ; Janine M. Hall-Porter^a ; Paula K. Schweitzer^a
• 关键词：CPAP ; Expiratory positive airway pressure ; Obstructive sleep apnea ; CPAP compliance ; Nasal device ; Sleep apnea treatment
• 刊名：Sleep Medicine
• 出版年：2011
• 出版时间：February 2011
• 年：2011
• 卷：12
• 期：2
• 页码：147-152
• 全文大小：286 K

文摘

Background

While continuous positive airway pressure (CPAP) effectively treats obstructive sleep apnea (OSA), adherence to CPAP is suboptimal. The short-term efficacy of and adherence with a convenient expiratory positive airway pressure (EPAP) nasal device was evaluated in OSA patients non-adherent with CPAP.

Methods

Participants were OSA patients who refused CPAP or used CPAP less than 3 h per night. After demonstrating tolerability to the EPAP device during approximately 1 week of home use, patients underwent a screening/baseline polysomnogram (PSG1) and a treatment PSG (PSG2). Patients meeting prespecified efficacy criteria underwent PSG3 after about 5 weeks of EPAP treatment.

Results

Forty-seven of 59 eligible patients (80 % ) tolerated the device and underwent PSG1. Forty-three patients (27 m, 16 f; 53.7 ± 10.9 years) met AHI entry criteria and underwent PSG2. Mean AHI decreased from 43.3 ± 29.0 at baseline to 27.0 ± 26.7 (p < 0.001) at PSG2. Twenty-four patients (56 % ) met efficacy criteria; their mean AHI was 31.9 ± 19.8, 11.0 ± 7.9, 16.4 ± 12.2 at PSG1, PSG2, and PSG3, respectively (p < 0.001, PSG1 vs. both PSG2 and PSG3). Mean Epworth Sleepiness Scale (ESS) scores were 12.3 ± 4.8 at baseline, 11.1 ± 5.1 at PSG1, and 8.7 ± 4.4 at PSG3 (p = 0.001 compared to baseline). Device use was reported an average of 92 % of all sleep hours.

Conclusions

The improvements in AHI and ESS, combined with the high degree of treatment adherence observed, suggest that the convenient EPAP device tested may become a useful therapeutic option for OSA.