@article {Kreivi652, author = {Hanna-Riikka Kreivi and Paula Maasilta and Adel Bachour}, title = {Persistence of Upper-Airway Symptoms During CPAP Compromises Adherence at 1 Year}, volume = {61}, number = {5}, pages = {652--657}, year = {2016}, doi = {10.4187/respcare.04113}, publisher = {Respiratory Care}, abstract = {BACKGROUND: The most common adverse effects of CPAP are related to the upper airways. We evaluated upper-airway symptoms before and after a CPAP trial as well as their effect on CPAP adherence. We also evaluated the effect of humidification added to CPAP therapy on upper-airway symptoms.METHODS: We followed for 1 y 536 subjects with obstructive sleep apnea scheduled consecutively for CPAP initiation. Subjects completed visual analog questionnaires on nasal stuffiness, rhinorrhea, and mouth dryness (0 = no symptoms, 100 = severe symptoms).RESULTS: Before CPAP initiation, mean nasal stuffiness score was 29.6 {\textpm} 24.9, rhinorrhea score was 16.0 {\textpm} 21.7, and mouth dryness score was 43.8 {\textpm} 33.1. In subjects who quit CPAP treatment before the 1-y follow-up, the increase in rhinorrhea score during CPAP initiation was significant, 5.3 (95\% CI 0.5{\textendash}9.5, P = .02), and in those using CPAP at 1 y, nasal stuffiness score and mouth dryness score decreased significantly during initiation, -5.1 (95\% CI -7.9 to -2.4, P \< .001) and -21.2 (-25.5 to -17.4, P \< .001). Mouth dryness score decreased significantly with CPAP regardless of humidification: change with humidification, -18.1 (95\% CI -22.1 to -14.3), P \< .001; change without, -10.5 (95\% CI -16.9 to -4.1), P = .002. Humidification also prevented the aggravation of rhinorrhea (change, -0.4 [95\% CI -2.6 to 1.9], P = .75) and alleviated nasal stuffiness (change -5.3 [95\% CI -7.8 to -2.6], P \< .001) with CPAP, whereas its absence induced a significant rise in symptom scores: change in rhinorrhea, 11.5 (95\% CI 7.1{\textendash}16.7), P \< .001; change in nasal stuffiness, 8.5 (95\% CI 3.9{\textendash}13.5, P \< .001).CONCLUSIONS: The severity of upper-airway symptoms before CPAP does not predict CPAP use at 1 y, whereas CPAP non-users at 1 y had smaller or no alleviation in symptom scores during initiation compared with those who continued CPAP treatment.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/61/5/652}, eprint = {https://rc.rcjournal.com/content/61/5/652.full.pdf}, journal = {Respiratory Care} }