Comparison of nose and face mask CPAP therapy for sleep apno

Interesting Comparison..." Improved face mask design is needed."




Comparison of nose and face mask CPAP therapy for sleep apnoea
I L Mortimore, A T Whittle, N J Douglas
+ Author Affiliations

Respiratory Medicine Unit, Department of Medicine, University of Edinburgh, Royal Infirmary, Edinburgh EH3 9YW, UK
Dr I L Mortimore, Scottish National Sleep Laboratory, Royal Infirmary, Edinburgh EH3 9YW, UK.
Received 18 April 1997
Revision requested 30 June 1997
Revised 10 December 1997
Accepted 12 December 1997
Abstract
BACKGROUND Many patients with sleep apnoea/hypopnoea syndrome (SAHS) find nasal continuous positive airway pressure (CPAP) treatment unsatisfactory due to side effects related to mouth air leakage. A study was performed to compare side effects with face mask and nose mask CPAP therapy in patients with SAHS, with and without uvulopalatopharyngoplasty (U3P).

METHODS Twenty newly diagnosed patients with SAHS took part in a randomised double limb trial of face or nose mask CPAP therapy (four weeks per limb) in which CPAP compliance in terms of machine run time was measured and patients answered a symptom questionnaire on side effects resulting from the mask. Ten patients with SAHS with U3P (SAHS/U3P) who were already regular users of nasal CPAP were also given a four week trial of face mask CPAP to compare compliance and symptoms. Ten patients with SAHS were matched with the 10 SAHS/U3P patients for body mass index, age, apnoea/hypopnoea index, and CPAP pressure. Long term compliance was estimated one year after the mask comparison studies.

RESULTS For patients with SAHS nightly compliance was higher with a nose mask (mean (SE) 5.3 (0.4) hours/night CPAP) than with a face mask (4.3 (0.5) hours/night CPAP), p = 0.01 (mean difference 1.0 hour/night, 95% CI 1.8 to 0.3). Nose masks were rated more comfortable by 19 of 20 patients (p<0.001) despite more mouth leak related symptoms. For SAHS/U3P patients compliance was marginally higher with nose masks (5.1 (0.7) hours/night CPAP) than with face masks (4.0 (0. hours/night CPAP), p = 0.07 (mean difference 1.1 hour/night, 95% CI 2.1 to 0.1). Nose masks were rated more comfortable by seven of 10 patients. There were no significant differences in side effect scores with face and nose masks. At one year nine of 10 SAHS patients and nine of 10 SAHS/U3P patients were still using CPAP. Compliance was 5.4 (0.6) hours/night for the SAHS patients and 3.5 (0.4) hours/night for the SAHS/U3P patients, p = 0.02 (mean difference 1.9 hour/night, 95% CI 3.6 to 0.3).

CONCLUSIONS Compliance is greater with nose mask CPAP than with face mask CPAP because the overall comfort is better and compensates for increased symptoms associated with mouth leakage. Improved face mask design is needed.

Interesting Comparison..." Improved face mask design is needed."

Uhhhhh .... that is a 17-year old study. Think there have been any innovations in FFM since then?


Gramps

Not to mention it is a very small study - 10 patients for each of the two mask types.

I used a few different FFMs all night, every night for years. Currently using an Innomed Hybrid which I find easier to use than nasal pillows. The mouthpiece makes a nice base for the nasal pillows to be secure.

Improved face mask design is needed.

Of course you can always say this about any product.

CONCLUSIONS Compliance is greater with nose mask CPAP than with face mask CPAP because the overall comfort is better and compensates for increased symptoms associated with mouth leakage.

Hogwash! Mouth leakage is potentially worse with a nasal mask but eliminated with a full face mask.

CPAP(dot)COM has a mask comparison guide. Compare to your heart's content.


Den

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Mouth leakage is potentially worse with a nasal mask but eliminated with a full face mask.

Good point. It should not be counted as compliance with a nasal interface if you are leaking from the mouth. The study's authors did not control for this.