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A convenient expiratory positive airway pressure nasal device for the treatment of sleep apnea in patients non-adherent with continuous positive airway pressure.
MedLine Citation:
PMID:  21256800     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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 3h per night. After demonstrating tolerability to the EPAP device during approximately 1week of home use, patients underwent a screening/baseline polysomnogram (PSG1) and a treatment PSG (PSG2). Patients meeting prespecified efficacy criteria underwent PSG3 after about 5weeks of EPAP treatment.
RESULTS: Forty-seven of 59 eligible patients (80%) tolerated the device and underwent PSG1. Forty-three patients (27m, 16f; 53.7±10.9years) 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.
Authors:
James K Walsh; Kara S Griffin; Elizabeth H Forst; Hasanali H Ahmed; Rhody D Eisenstein; Denise Troy Curry; Janine M Hall-Porter; Paula K Schweitzer
Publication Detail:
Type:  Journal Article     Date:  2011-01-21
Journal Detail:
Title:  Sleep medicine     Volume:  12     ISSN:  1878-5506     ISO Abbreviation:  Sleep Med.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100898759     Medline TA:  Sleep Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  147-52     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier B.V. All rights reserved.
Affiliation:
Sleep Medicine and Research Center, St. Luke's Hospital, 232 S. Woods Mill Rd., Chesterfield, MO, USA; Department of Psychology, Saint Louis University, St. Louis, MO, USA.
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