Abstract
BACKGROUND: The addition of heated humidification to CPAP has been shown to improve nasal adverse effects in subjects with obstructive sleep apnea (OSA). However, current data regarding improvement in CPAP adherence is conflicting. Furthermore, there are no data from a tropical climate area with a high humidity level.
METHODS: In this prospective randomized crossover study conducted in Thailand, subjects with moderate to severe OSA with nasopharyngeal symptoms post-split-night study were enrolled in the study. Subjects were randomly assigned to receive CPAP with or without heated humidification for 4 weeks and then crossed over. Information on CPAP adherence, quality of life assessed by the Functional Outcomes of Sleep Questionnaire, nasopharyngeal symptoms assessed by a modified XERO questionnaire, and bedroom ambient humidity and temperature data were obtained.
RESULTS: Data were collected on 20 subjects with OSA during the period of January to December 2014. Although the addition of heated humidification appeared to improve average hours of use for all days when compared with conventional CPAP, the difference was not statistically significant (CPAP with heated humidification = 4.6 ± 1.7 h/night; conventional CPAP = 4.0 ± 1.7 h/night, P = .1). However, the addition of heated humidification improved CPAP adherence on the days of use (5.5 ± 1.5 h/night) compared with conventional CPAP (5.2 ± 1.4 h/night), P = .033. Quality of life was also improved according to the Functional Outcomes of Sleep Questionnaire score (median 17.6 [interquartile range 3.5]) in the heated humidification group compared with conventional CPAP group (median 17.6 [interquartile range 4.5]), P = .046. Significant reduction in the dry throat/sore throat symptom was noted only when CPAP with heated humidification was used.
CONCLUSIONS: Even in a tropical climate area, CPAP adherence and quality of life appeared to improve when heated humidification was employed in subjects with moderate to severe OSA with nasopharyngeal symptoms post-split-night polysomnography. The improvement may be related to a reduction in the dry throat/sore throat symptom.
Footnotes
- Correspondence: Naricha Chirakalwasan MD, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Medicine, Chulalongkorn University, 1873 Rama IV Road, Pathumwan, Bangkok, Thailand 10330. E-mail: narichac{at}hotmail.com.
This work was supported by the Ratchadaphiseksomphot Endowment Fund of Chulalongkorn University. All CPAP machines and related equipment were sponsored by Fisher and Paykel Healthcare Limited. However, the company had no impact on study design or interpretation of the results of the study. SR has disclosed relationships with Sanofi, Medtronic, and Merck. The other authors have disclosed no conflicts of interest.
Dr Soudorn presented a version of this work at the Annual Meeting of The Royal College of Physicians of Thailand, held March 26–29, 2015 at Bangkok Convention Centara at Central World in Bangkok, Thailand.
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