0
Clinical Investigations: SLEEP AND BREATHING |

Effects of Humidification on Nasal Symptoms and Compliance in Sleep Apnea Patients Using Continuous Positive Airway Pressure*

Clifford A. Massie, PhD; Robert W. Hart, MD, FCCP; Kathleen Peralez; Glenn N. Richards, MD
Author and Funding Information

*From the Alexian Brothers Medical Center (Drs. Massie and Hart), Elk Grove Village, IL; Central DuPage Hospital (Ms. Peralez), Winfield, IL; and Respiratory Services (Dr. Richards), Green Lane Hospital, Auckland, New Zealand.

Correspondence to: Clifford A. Massie, PhD, Suburban Lung Associates, 810 Biesterfield Rd, Suite 404, Elk Grove Village, IL 60007; e-mail: CMassie@AOL.com



Chest. 1999;116(2):403-408. doi:10.1378/chest.116.2.403
Text Size: A A A
Published online

Study objectives: To evaluate the effects of humidification on nasal symptoms and compliance in sleep apnea patients using continuous positive airway pressure (CPAP).

Design: A randomized, crossover design was employed.

Setting: The study was conducted at two suburban community-based hospital sleep laboratories.

Patients: Data were collected on 38 obstructive sleep apnea patients (mean age, 44.1 years) in whom CPAP was a novel treatment.

Interventions: The interventions were heated humidity, cold passover humidity, and a washout period without humidity.

Measurements and results: Patients were titrated with heated humidity or cold passover humidity in the laboratory and subsequently initiated on humidity. Objective compliance, self-report of factors affecting CPAP use, satisfaction with CPAP, feeling upon awakening, and daytime sleepiness were assessed at the completion of each 3-week treatment period and a 2-week washout period. Outcome measures were assessed with one-way analysis of variance followed by Scheffe post hoc comparisons. Significant main effects were observed for compliance (F2,37 = 5.2; p = 0.008), satisfaction with CPAP (F2,37 = 4.5; p = 0.01), and feeling refreshed on awakening (F2,37 = 4.4; p = 0.02). A significant decrease in daytime sleepiness was observed between baseline and each of the conditions (F3,37 = 55.5; p < 0.0001), but Epworth sleepiness scale scores did not differ between conditions (all p values > 0.56). CPAP use with heated humidity (5.52 ± 2.1 h/night) was greater than CPAP use without humidity (4.93 ± 2.2 h/night; p = 0.008). Compliance differences were not observed between CPAP use with cold passover humidity and CPAP use without humidity. Patients were more satisfied with CPAP when it was used with heated or cold passover humidity (p ≤ 0.05). However, only heated humidity resulted in feeling more refreshed on awakening (p < 0.05). No significant differences were observed among the three groups on the global adverse side effect score (F2,37 = 2.5; p = 0.09). Specific side effects such as dry mouth or throat and dry nose were reported less frequently when CPAP was used with heated humidity compared to CPAP use without humidity (p < 0.001).

Conclusions: Compliance with CPAP is enhanced when heated humidification is employed. This is likely due to a reduction in side effects associated with upper airway symptoms and a more refreshed feeling upon awakening. Compliance gains may be realized sooner if patients are started with heated humidity at CPAP initiation.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543