Effects of heated humidification and topical steroids on compliance, nasal symptoms, and quality of life in patients with obstructive sleep apnea syndrome using nasal continuous positive airway pressure.

Hdl Handle:
http://hdl.handle.net/10147/207620
Title:
Effects of heated humidification and topical steroids on compliance, nasal symptoms, and quality of life in patients with obstructive sleep apnea syndrome using nasal continuous positive airway pressure.
Authors:
Ryan, Silke; Doherty, Liam S; Nolan, Geraldine M; McNicholas, Walter T
Affiliation:
Sleep Research Laboratory, St. Vincent's University Hospital, Dublin, Ireland.
Citation:
J Clin Sleep Med. 2009 Oct 15;5(5):422-7.
Journal:
Journal of clinical sleep medicine : JCSM : official publication of the American , Academy of Sleep Medicine
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207620
PubMed ID:
19961025
Abstract:
BACKGROUND: Nasal side effects are common in patients with obstructive sleep apnea syndrome (OSAS) starting on nasal continuous positive airway pressure (CPAP) therapy. We tested the hypothesis that heated humidification or nasal topical steroids improve compliance, nasal side effects and quality of life in this patient group. METHODS: 125 patients with the established diagnosis of OSAS (apnea/hypopnea index > or = 10/h), who tolerated CPAP via a nasal mask, and who had a successful CPAP titration were randomized to 4 weeks of dry CPAP, humidified CPAP or CPAP with additional topical nasal steroid application (fluticasone, GlaxoWellcome). Groups were similar in all demographic variables and in frequency of nasal symptoms at baseline. Outcome measures were objective compliance, quality of life (short form 36), subjective sleepiness (Epworth Sleepiness Scale score) and nasal symptoms such as runny, dry or blocked nose, sneezing and headaches; all variables assessed using a validated questionnaire and by direct interview. RESULTS: There was no difference in compliance between groups after 4 weeks (dry: 5.21 +/- 1.66 h/night, fluticasone: 5.66 +/- 1.68, humidifier: 5.21 +/- 1.84; p = 0.444). Quality of life and subjective sleepiness improved in all groups, but there were no differences in the extent of improvement. Nasal Symptoms were less frequently reported in the humidifier group (28%) than in the remaining groups (dry: 70%, fluticasone: 53%, p = 0.002). However, the addition of fluticasone resulted in increased frequency of sneezing. CONCLUSION: The addition of a humidifier, but not nasal steroids decreases the frequency of nasal symptoms in unselected OSAS patients initiating CPAP therapy; however compliance and quality of life remain unaltered.
Language:
eng
MeSH:
Administration, Topical; Analysis of Variance; Androstadienes/administration & dosage/*therapeutic use; Anti-Inflammatory Agents/administration & dosage/therapeutic use; Continuous Positive Airway Pressure/*methods; Female; Hot Temperature; Humans; *Humidity; Male; Middle Aged; Nasal Obstruction/prevention & control; Patient Compliance/*statistics & numerical data; Prospective Studies; *Quality of Life; Questionnaires; *Respiratory Physiological Processes; Sleep Apnea, Obstructive/*therapy
ISSN:
1550-9389 (Print); 1550-9389 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorRyan, Silkeen_GB
dc.contributor.authorDoherty, Liam Sen_GB
dc.contributor.authorNolan, Geraldine Men_GB
dc.contributor.authorMcNicholas, Walter Ten_GB
dc.date.accessioned2012-02-01T10:33:05Z-
dc.date.available2012-02-01T10:33:05Z-
dc.date.issued2012-02-01T10:33:05Z-
dc.identifier.citationJ Clin Sleep Med. 2009 Oct 15;5(5):422-7.en_GB
dc.identifier.issn1550-9389 (Print)en_GB
dc.identifier.issn1550-9389 (Linking)en_GB
dc.identifier.pmid19961025en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207620-
dc.description.abstractBACKGROUND: Nasal side effects are common in patients with obstructive sleep apnea syndrome (OSAS) starting on nasal continuous positive airway pressure (CPAP) therapy. We tested the hypothesis that heated humidification or nasal topical steroids improve compliance, nasal side effects and quality of life in this patient group. METHODS: 125 patients with the established diagnosis of OSAS (apnea/hypopnea index > or = 10/h), who tolerated CPAP via a nasal mask, and who had a successful CPAP titration were randomized to 4 weeks of dry CPAP, humidified CPAP or CPAP with additional topical nasal steroid application (fluticasone, GlaxoWellcome). Groups were similar in all demographic variables and in frequency of nasal symptoms at baseline. Outcome measures were objective compliance, quality of life (short form 36), subjective sleepiness (Epworth Sleepiness Scale score) and nasal symptoms such as runny, dry or blocked nose, sneezing and headaches; all variables assessed using a validated questionnaire and by direct interview. RESULTS: There was no difference in compliance between groups after 4 weeks (dry: 5.21 +/- 1.66 h/night, fluticasone: 5.66 +/- 1.68, humidifier: 5.21 +/- 1.84; p = 0.444). Quality of life and subjective sleepiness improved in all groups, but there were no differences in the extent of improvement. Nasal Symptoms were less frequently reported in the humidifier group (28%) than in the remaining groups (dry: 70%, fluticasone: 53%, p = 0.002). However, the addition of fluticasone resulted in increased frequency of sneezing. CONCLUSION: The addition of a humidifier, but not nasal steroids decreases the frequency of nasal symptoms in unselected OSAS patients initiating CPAP therapy; however compliance and quality of life remain unaltered.en_GB
dc.language.isoengen_GB
dc.subject.meshAdministration, Topicalen_GB
dc.subject.meshAnalysis of Varianceen_GB
dc.subject.meshAndrostadienes/administration & dosage/*therapeutic useen_GB
dc.subject.meshAnti-Inflammatory Agents/administration & dosage/therapeutic useen_GB
dc.subject.meshContinuous Positive Airway Pressure/*methodsen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHot Temperatureen_GB
dc.subject.meshHumansen_GB
dc.subject.mesh*Humidityen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshNasal Obstruction/prevention & controlen_GB
dc.subject.meshPatient Compliance/*statistics & numerical dataen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.mesh*Quality of Lifeen_GB
dc.subject.meshQuestionnairesen_GB
dc.subject.mesh*Respiratory Physiological Processesen_GB
dc.subject.meshSleep Apnea, Obstructive/*therapyen_GB
dc.titleEffects of heated humidification and topical steroids on compliance, nasal symptoms, and quality of life in patients with obstructive sleep apnea syndrome using nasal continuous positive airway pressure.en_GB
dc.contributor.departmentSleep Research Laboratory, St. Vincent's University Hospital, Dublin, Ireland.en_GB
dc.identifier.journalJournal of clinical sleep medicine : JCSM : official publication of the American , Academy of Sleep Medicineen_GB
dc.description.provinceLeinster-
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