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Nasal and Oronasal Mask: literature x clinical practice
CPAP is considered the gold standard of treatment for OSA. The effectiveness of the treatment is associated with the proper use of the device and directly related to the type of mask used. Recent studies show that the nasal mask is the most suitable for providing greater comfort and effectiveness, but in clinical practice we still face the need for adaptation of the oronasal mask.
To compare medium-term adherence, AHI, leakage and therapeutic pressure of OSA patients who use oronasal and nasal mask in a CPAP clinic.
Retrospective design study, where patients with AHI ≥30 events/hour were selected, classified as severe on polysomnography examination, and subsequently titrated by polysomnography with CPAP. They should be in CPAP treatment for 90 to 360 days, using nasal or oronasal mask, aged 45 to 80 years, both genders. Patients who changed their mask during treatment were excluded. Good adherence was considered the percentage of use ≥70% and the average hours of use ≥4 hr. For excessive leakage, it was considered above 24 l/min using AirView-Resmed monitoring.
220 patients were located, 201 wearing nasal masks and 19 oronasal. When matched for age, gender and severity, each group remained with 9 patients. The adherence of patients with nasal mask was 81.5% compared to 68.2% with oronasal mask (p <0.05). The difference in AHI was 4.7 events/hour (p <0.05). When comparing treatment pressure and mask leak we noticed that in the oronasal mask the leak is clinically higher, but without statistical difference.
In clinical practice we still face the need to adapt the oronasal mask, but even in this scenario we have worse adherence and increased residual AHI.
CPAP, OSA, nasal and oronasal mask.
Alessandra Coelho Seixinho, Denis Mesquita, Patricia Sant'Anna, Ana Cecilia Taddei, Lara Freitas Assumpção Oliveira, Gabriela Zanussi