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* From the Physiological Sciences Graduate Program, Biomedical Center, Federal University of Espirito Santo (Ms. Martins de Araújo and Dr. Vasquez) and the Unit for Research in Sleep Disorders (UNI-SONO) of Espirito Santo (Dr. Barros Vieira), Vitoria, ES, Brazil, and the Unité de Sommeil, Service de Pneumologie, Hôpital Saint-Antoine (Dr. Fleury), Paris, France.
Correspondence to: Bernard Fleury, MD, Unité de Sommeil, Service de Pneumologie, Hôpital Saint-Antoine, 184, Rue du Faubourg Saint-Antoine 75571, Paris, Cedex 12, France; e-mail: bernard.fleury{at}sat.ap-hop-paris.fr
Study objectives: The objectives of this study were (1) to evaluate the way in which nasal continuous positive airway pressure (CPAP) therapy influences the relative humidity (rH) of inspired air; and (2) to assess the impact on rH of the addition of an integrated heated humidifier or a full face mask to the CPAP circuitry.
Design: The studies were performed in 25 patients with obstructive sleep apnea syndrome receiving long-term nasal CPAP therapy and complaining of nasal discomfort. During CPAP administration, temperature and rH were measured in the mask either during a night’s sleep for 8 patients or during a daytime study in which the effects of mouth leaks were simulated in 17 patients fitted with either a nasal mask (with or without humidification) or a face mask alone.
Setting: University hospital sleep disorders center.
Measurements and results: Compared with the values obtained with CPAP alone, integrated heated humidification significantly increased rH during the sleep recording, both when the mouth was closed (60 ± 14% to 81 ± 14%, p < 0.01) and during mouth leaks (43 ± 12% to 64 ± 8%, p < 0.01). During the daytime study, a significant decrease in rH was observed with CPAP alone. Compared with the values measured during spontaneous breathing without CPAP (80 ± 2%), the mean rH was 63 ± 9% (p < 0.01) with the mouth closed and 39 ± 9% (p < 0.01) with the mouth open. The addition of heated humidification to CPAP prevented rH changes when the mouth was closed (82 ± 12%), but did not fully prevent the rH decrease during simulation of mouth leaks (63 ± 9%) compared with the control period (80 ± 2%, p < 0.01). Finally, attachment of a face mask to the CPAP circuitry prevented rH changes both with the mouth closed (82 ± 9%) and with the mouth open (84 ± 8%).
Conclusions: These data indicate that inhaled air dryness during CPAP therapy can be significantly attenuated by heated humidification, even during mouth leaks, and can be totally prevented by using a face mask.
Key Words: continuous positive airway pressure therapy • face mask • heated humidification • obstructive sleep apnea syndrome
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