SESSION TITLE: Sleep Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM
PURPOSE: Vorona et al. (2007) described severe obstructive sleep apnea (OSA) responding to the use of a chinstrap alone in a patient who had stopped using a continuous positive airway pressure (CPAP) device for two months. They reported an improved apnea-hypopnea index (AHI) and oxygen saturation with chinstrap use, and suggested that chinstraps merit investigation as treatment for OSA. We performed this study to determine if a chinstrap alone was an alternative to CPAP in the treatment of OSA
METHODS: 27 adult subjects with AHIs 5/hr or greater on initial diagnostic polysomnography (PSG) were enrolled. All subjects underwent a modified split titration study (wearing a chinstrap alone for the first two hours of sleep, and titrated for the rest of the night with CPAP in the standard method without a chinstrap). We compared the general AHIs and oxygen saturation nadirs during the diagnostic PSG with those obtained during the chinstrap portion of the modified split study and on the optimal CPAP pressure. Non-parametrical statistical methods were used throughout. Data are presented as median; interquartile range (IQR).
RESULTS: There was no statistically significant difference between the diagnostic AHI (16.0/hour; 9.8 to 26.0/hour) and the chinstrap AHI (22.4/ hour; 10.8 to 40.3/hour). However, there was a statistically significant difference between the diagnostic AHI and the optimal CPAP AHI (2.3/ hour; 1.0 to 5.2/ hour) (p<0.001). There was no statistically significant difference between the diagnostic oxygen saturation nadir (84.5%; 80.0 to 88.0%) and the chinstrap oxygen saturation nadir (87.0; 84.0 to 89.0%). However, there was a statistically significant difference between the diagnostic oxygen saturation nadir and the optimal CPAP oxygen saturation nadir (93.0%; 91.0 to 94.3%)(p<0.001).
CONCLUSIONS: A chinstrap alone does not produce statistically significant improvements in AHI and oxygen saturation nadirs in patients with OSA, and is not an effective alternative to CPAP therapy.
CLINICAL IMPLICATIONS: The use of a chin strap alone should not be offered to patients for the treatment of OSA. CPAP remains the gold standard for treatment.
DISCLOSURE: The following authors have nothing to disclose: Neola Gushway-Henry, Sushanth Bhat, Sandeep Riar, Vincent DeBari, Disha Patel, Justin Pi, Liudmila Lysenko, Divya Gupta, Sudhansu Chokroverty, Peter Polos
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