Abstract
Backgroundand Objectives: Obstructive sleep apnea (OSA) patients may remove their mask unconsciously during automatic continuous positive airway pressure (Auto-CPAP) therapy and therefore cannot receive good treatment. The discomfort from the airflow of Auto-CPAP may be one reason for interrupted sleep. Sens Awake (SA) can detect the arousal and lower the pressure to prevent patients from fully awakening from sleep. Materials and Methods: To evaluate the effect of SA, we designed a prospective, randomized, crossover trial comparing Auto-CPAP with and without SA on Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Nasal Obstruction Symptom Evaluation (NOSE) Scale and recorded data from the auto-CPAP machine. Results: In the 25 patients who completed the study, the gender, age, body mass index, neck circumference, polysomnography data, and previous CPAP use were not significantly different between the two arms. The average and 90th percentile pressures were significantly lower during SA on (SA on vs. off: 6.9 ± 2.7 vs. 7.3 ± 2.6 [p = 0.032] and 8.6 ± 3.0 vs. 9.2 ± 2.9 [p = 0.002], respectively). The time used, days used, compliance, average and 90th percentile leaks, and the residual Apnea-Hypopnea Index (AHI) were not significantly changed between the SA on-and-off. Based on the subjective evaluation, PSQI, ESS, and NOSE were not significantly different between the SA on-and-off; however, based on additional analyses which were compared with baseline data, the ESS was significantly lower when the SA was on (SA on vs. baseline: 11.1 ± 6.1 vs. 13.2 ± 6.0 [p = 0.023]). Conclusions: CPAP therapy with or without two weeks of the SA had a similar effect on CPAP use, sleep quality, daytime sleepiness, and nasal obstruction. The SA may have a tendency to improve daytime sleepiness, but needs further study with a longer duration of treatment.
Highlights
Obstructive sleep apnea syndrome (OSA) is prevalent and has severe consequences without adequate treatment [1]
The continuity of Continuous positive airway pressure (CPAP) use has a dose-dependent effect on the consequences of OSA [5]; some OSA patients may remove the mask themselves while sleeping, which leads to poor compliance and an insufficient CPAP therapy effect [6]
We screened 415 OSA patients and who were recommended to receive CPAP therapy; 249 patients agreed to CPAP therapy, while the remaining patients chose to research other treatment options
Summary
Obstructive sleep apnea syndrome (OSA) is prevalent and has severe consequences without adequate treatment [1]. Continuous positive airway pressure (CPAP) ventilator therapy is the first-line treatment for OSA patients and is effective in improving OSA symptoms [3]. The continuity of CPAP use has a dose-dependent effect on the consequences of OSA [5]; some OSA patients may remove the mask themselves while sleeping, which leads to poor compliance and an insufficient CPAP therapy effect [6]. Obstructive sleep apnea (OSA) patients may remove their mask unconsciously during automatic continuous positive airway pressure (Auto-CPAP) therapy and cannot receive good treatment. Conclusions: CPAP therapy with or without two weeks of the SA had a similar effect on CPAP use, sleep quality, daytime sleepiness, and nasal obstruction. The SA may have a tendency to improve daytime sleepiness, but needs further study with a longer duration of treatment
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