Chest
Clinical InvestigationsSLEEP AND BREATHINGMouth Breathing Compromises Adherence to Nasal Continuous Positive Airway Pressure Therapy
Section snippets
Patients
From 231 consecutive CPAP-naive patients referred for snoring and a variable degree of daytime sleepiness, 119 patients were excluded because their respiratory disturbance index (RDI) was < 15/h. We also excluded 19 patients: 3 patients with a stroke < 1 year previously, 2 patients with severe psychiatric illness, 5 patients with a prior uvulopalatopharyngoplasty, 3 patients with persistent nasal symptoms, 1 patient who refused CPAP, and 5 patients to whom nasal surgical intervention was
Baseline Demographics and Sleep Characteristics
We studied 51 patients (4 women). MBs and NBs did not differ with respect to age, sex, body mass index (BMI), neck circumference (NC), ESS, AUDIT score, TST, TST while supine, rapid eye movement (REM) sleep, wakefulness after sleep onset (WASO), sleep efficiency, RDI while supine, or pulse oxygen saturation (Spo2) awake. Meanwhile, total arousal, respiratory arousal, RDI, and an oxygen desaturation index of 4% (ODI4) were higher in MBs, but the amount of delta sleep was lower. By design, the
Discussion
The main finding of this study is that in patients with SDB, a high percentage of mouth breathing during sleep represents a risk for low adherence to CPAP. Furthermore, although mouth breathing decreases considerably when patients are put on nasal CPAP, MBs still have considerably more mouth breathing on CPAP than do NBs. We also found a significant correlation in all patients between use of CPAP at 1 month and its long-term use. These findings are consistent with others, that mouth leak may
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