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Type of Mask May Impact on Continuous Positive Airway Pressure Adherence in Apneic Patients

Author

Listed:
  • Jean Christian Borel
  • Renaud Tamisier
  • Sonia Dias-Domingos
  • Marc Sapene
  • Francis Martin
  • Bruno Stach
  • Yves Grillet
  • Jean François Muir
  • Patrick Levy
  • Frederic Series
  • Jean-Louis Pepin
  • on behalf of the Scientific Council of The Sleep Registry of the French Federation of Pneumology (OSFP)

Abstract

Rationale: In obstructive sleep apnea patients (OSA), continuous positive airway pressure (CPAP) adherence is crucial to improve symptoms and cardiometabolic outcomes. The choice of mask may influence CPAP adherence but this issue has never been addressed properly. Objective: To evaluate the impact of nasal pillows, nasal and oronasal masks on CPAP adherence in a cohort of OSA. Methods: Newly CPAP treated OSA participating in “Observatoire Sommeil de la Fédération de Pneumologie”, a French national prospective cohort, were included between March 2009 and December 2011. Anthropometric data, medical history, OSA severity, sleepiness, depressive status, treatment modalities (auto-CPAP versus fixed pressure, pressure level, interface type, use of humidifiers) and CPAP-related side effects were included in multivariate analysis to determine independent variables associated with CPAP adherence. Results: 2311 OSA (age = 57(12) years, apnea+hypopnea index = 41(21)/h, 29% female) were included. Nasal masks, oronasal masks and nasal pillows were used by 62.4, 26.2 and 11.4% of the patients, respectively. In univariate analysis, oronasal masks and nasal pillows were associated with higher risk of CPAP non-adherence. CPAP non-adherence was also associated with younger age, female gender, mild OSA, gastroesophageal reflux, depression status, low effective pressure and CPAP-related side effects. In multivariate analysis, CPAP non-adherence was associated with the use of oronasal masks (OR = 2.0; 95%CI = 1.6; 2.5), depression, low effective pressure, and side effects. Conclusion: As oronasal masks negatively impact on CPAP adherence, a nasal mask should be preferred as the first option. Patients on oronasal masks should be carefully followed.

Suggested Citation

  • Jean Christian Borel & Renaud Tamisier & Sonia Dias-Domingos & Marc Sapene & Francis Martin & Bruno Stach & Yves Grillet & Jean François Muir & Patrick Levy & Frederic Series & Jean-Louis Pepin & on b, 2013. "Type of Mask May Impact on Continuous Positive Airway Pressure Adherence in Apneic Patients," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-8, May.
    • Handle: RePEc:plo:pone00:0064382
    DOI: 10.1371/journal.pone.0064382
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    References listed on IDEAS

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    1. Frédéric Gagnadoux & Marc Le Vaillant & François Goupil & Thierry Pigeanne & Sylvaine Chollet & Philippe Masson & Marie-Pierre Humeau & Acya Bizieux-Thaminy & Nicole Meslier & the IRSR sleep cohort gr, 2011. "Influence of Marital Status and Employment Status on Long-Term Adherence with Continuous Positive Airway Pressure in Sleep Apnea Patients," PLOS ONE, Public Library of Science, vol. 6(8), pages 1-7, August.
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