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Sleep Disorders |

Selection of CPAP Interface: A Pilot Study to Compare Initial Sleep Technologists' Recommendation of Interface With Patients' Preferred Choice After a Trial of the Interfaces

Rui Ya Soh, MMed; Leong Chai Leow; Song Tar Toh; Hong Juan Han; Gan Liang Tan; Cheah Hooi Ken Lee; Pei Rong Song; Siti Raudha; Siti Zakiah; Thun How Ong
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Singapore General Hospital, Singapore, Singapore


Chest. 2015;148(4_MeetingAbstracts):1060A. doi:10.1378/chest.2271869
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Abstract

SESSION TITLE: Sleep Disorders Posters II: Consequences of OSA and Treatment

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Choice of interface is an important determinant of patient’s CPAP experience and may impact compliance but there is little objective data or criteria to determine which interface to use.We conducted a pilot study comparing initial sleep technologist recommendations (TP) and patients' initial preference (IP) after a 5-minute trial of each of three different interfaces (nasal masks, oronasal, nasal pillows) with patients' final preferred interface (FP) after a one month trial of each of the interface. We also examined if compliance is better with the preferred interfaces.

METHODS: 20 newly diagnosed patients with AHI ≥15 who were treatment naiive and had no contraindications for CPAP were recruited.TP were recorded. Patients underwent 5-minute trial of each of the 3 interfaces at a fixed setting of CPAP6cmH2O and nominated their IP. Patients then underwent a 1-month trial of each of the 3 interfaces in randomized order. FP, compliance and leakage data with each interface was recorded. All patients were on autoPAP mode with heated humidfication.

RESULTS: For 5-minute trial, 38.9%(n=7) patients chose nasal masks, 16.7%(n=3) oronasal and 44.4%(n=8) nasal pillows. Among technicians’ prediction, 33.3%(n=6) were for nasal masks, 11.1%(n=2) oronasal and 55.6%(n=10) nasal pillows. At the end of 3-month trial, 55.6%(n=10) patients chose nasal masks, 16.7%(n=3) oronasal and 27.8%(n=5) nasal pillows. 44.4%(n=8) chose the same interface for 5-minute and end of 3-month trial. 44.4%(n=8) patients chose the same interface at end of 3-month trial as what technicians predicted. There was no significant difference in mean average hours of CPAP usage per night for preferred interface chosen at the end of 3-month trial (4.546h) compared to other interfaces (4.408hr).

CONCLUSIONS: This pilot study shows that both TP and IP only match FP in less than 50% of the time. There was no significant difference in compliance with the preferred interfaces. This may be due to small sample but may also suggest that patients’ preference may not be indicative of the most appropriate interfaces.

CLINICAL IMPLICATIONS: Neither the technologist’s initial recommendation nor patient choice after the initial trial accurately predicted the patient’s final preferred interface. Further studies need to be done to investigate for more reliable measures to predict appropriate interfaces.

DISCLOSURE: The following authors have nothing to disclose: Rui Ya Soh, Leong Chai Leow, Song Tar Toh, Hong Juan Han, Gan Liang Tan, Cheah Hooi Ken Lee, Pei Rong Song, Siti Raudha, Siti Zakiah, Thun How Ong

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