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Adverse effects of nasal continuous positive airway pressure therapy in sleep apnoea syndrome

Published online by Cambridge University Press:  29 June 2007

A. Kalan*
Affiliation:
Department of Otolaryngology and Academic Department of Respiratory Medicine St. Bartholomew's and Royal London School of Medicine and Dentistry, London, UK
G. S. Kenyon
Affiliation:
Department of Otolaryngology and Academic Department of Respiratory Medicine St. Bartholomew's and Royal London School of Medicine and Dentistry, London, UK
T. A. R. Seemungal
Affiliation:
Department of Otolaryngology and Academic Department of Respiratory Medicine St. Bartholomew's and Royal London School of Medicine and Dentistry, London, UK
J. A. Wedzicha
Affiliation:
Department of Otolaryngology and Academic Department of Respiratory Medicine St. Bartholomew's and Royal London School of Medicine and Dentistry, London, UK
*
Address for correspondence: Mr A. Kalan F.R.C.S. (Ed.), 11 Arrowhead Court, James Lane, Leytonstone, London Ell INT. Fax: 0181 558 3134 e-mail: [email protected]

Abstract

Nasal continuous positive airway pressure (nCPAP) is now the treatment of choice for patients with sleep apnoea syndrome. Side-effects and adverse reactions have been described in isolated reports with this device. We have, therefore, systematically studied the side-effects of nCPAP therapy in 300 consecutive patients referred to the London Chest Hospital Ventilatory Support Unit. Ninety-six per cent of patients complained of at least one side-effect resulting from the therapy, with 45 per cent complaining of a side-effect specific to the nasal mask. There was no correlation between the side-effects and level of pressure used during nCPAP. The rate of compliance remained high in spite of the side-effects, with a daily use of 7.8 hours (SD 8.05) and with 83 per cent of the patients using the device every night. Although nCPAP treatment remains acceptable to most patients there exists a high incidence of adverse effects.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1999

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References

Bedard, M. A., Montplaisir, J., Richer, F. (1991) Nocturnal hypoxemia as a determinant of vigilance impairment in sleep apnoea syndrome. Chest 100: 367370.Google Scholar
Engleman, H. M., Martine, S. E., Douglas, N. J. (1994) Compliance with CPAP therapy in patients with sleep apnoea/hypopnoea syndrome. Thorax 49: 263266.Google Scholar
Findley, L. J., Unverzagt, M. E., Suratt, P. M. (1988) Automobile accidents involving patients with obstructive sleep apnoea. American Review of Respiratory Disease 138: 337340.CrossRefGoogle Scholar
Guilleminault, C., Van Den Hoed, J., Mitler, M. M. (1978) Clinical overview of the sleep apnoea syndrome. In Sleep Apnoea Syndromes. (Guilleminault, C., Dement, W. C., eds.), A. R. Liss, New York, pp 112.Google Scholar
Hoffstein, V., Chan, C. K., Slutsky, A. S. (1991) Sleep apnoea and systemic hypertension: a casual association. American Journal of Medicine 91: 190196.CrossRefGoogle Scholar
Hoffstein, V., Viner, S., Mateika, S. (1992) Treatment of obstructive sleep apnoea with nasal continuous positive pressure: Patient compliance, perception of benefits and side effects. American Review of Respiratory Disease 145: 841845.CrossRefGoogle Scholar
Hoffstein, V., Zamel, N., Phillipson, E. A. (1984) Lung volume dependence of pharyngeal cross-sectional area in patients with obstructive sleep apnoea. American Review of Respiratory Disease 130: 175178.CrossRefGoogle Scholar
Koskenvuo, M, Kaprio, J., Telakivi, T. (1987) Snoring as a risk factor for ischaemic heart disease and stroke in men. British Medical Journal 294: 1619.Google Scholar
Kribbs, N. B., Pack, A. I., Kline, L. R. (1993) Objective measurement of patterns of nasal CPAP used by patients with obstructive sleep apnoea. American Review of Respiratory Disease 147: 887895.Google Scholar
Kryger, M. H. (1994) Management of obstructive sleep apnoea: overview. In Principles and Practice of Sleep Medicine. 2nd Edition, (Kryger, M. H., Roth, T., Dement, W. C., eds.). W. B. Saunders, Philadelphia, pp 736747.Google Scholar
Kryger, M. H. (1992) Management of obstructive sleep apnoea. Clinical Chest Medicine 13: 481492.CrossRefGoogle Scholar
Leger, P., Robert, D., Langwin, B. (1992) Chest wall deformities due to idiopathic kyphoscoliosis or sequelae of tuberculosis. European Respiratory Review 2: 362368.Google Scholar
Levinson, P. D., Millman, R. P. (1991) Causes and consequences of blood pressure alterations in obstructive sleep apnoea. Archives of Internal Medicine 151: 455462.Google Scholar
Meecham, Jones D. J., Wedzicha, J. A. (1994) Nasal masks for positive pressure ventilation: Survey of patient usage. Thorax 49: 811812.Google Scholar
Pepin, J. L., Leger, P., Veale, D., Langevin, B., Robert, D., Levy, P. (1995) Side effects of nasal continuous positive airway pressure in sleep apnoea syndrome. Chest 107: 375381.Google Scholar
Rajagopal, K. R., Bennett, L. L., Dillard, T. A., Tellis, C. J., Tenholder, M. F. (1986) Overnight nasal CPAP improves hypersomnolence in sleep apnoea. Chest 90: 172176.Google Scholar
Rauscher, H., Popp, W., Wanke, T. (1991) Acceptance of CPAP therapy for sleep apnea syndrome. Chest 100: 10191023.Google Scholar
Riley, R. W., Powell, N. B., Guilleminault, C. (1990) Maxillofacial surgery and nasal CPAP: a comparison of treatment for obstructive sleep apnoea syndrome. Chest 98: 14211425.Google Scholar
Rodenstein, D. O. (1992) Assessment of uvulopalatophar-yngoplasty for the treatment of the sleep apnoea syndrome. Sleep 15: S52S56.CrossRefGoogle Scholar
Series, F., St Pierre, S., Carrier, G. (1993) Surgical correction of nasal obstruction in the treatment of mild sleep apnoea: Importance of cephalometry in predicting outcome. Thorax 48: 360363.Google Scholar
Shiner, R. J., Carroll, N., Sawicka, E. H., Simmond, A. K., Braithwaite, M. A. (1990) Role of nocturnal hypoxemia in the genesis of systemic hypertension. Cardiology 77: 2529.Google Scholar
Strohl, K. P., Chemiack, N. S., Gothe, B. (1986) Physiologic basis of therapy for sleep apnoea. American Review of Respiratory Disease 134: 791802.Google Scholar
Sullivan, C. E., Grunstein, R. R. (1994) Continuous positive airway pressure in sleep-disordered breathing. In Principles and Practice of Sleep Medicine, 2nd Edition, (Kryger, M. H., Roth, T., Dement, W. C., eds.). W. B. Saunders, Philadelphia, pp 694705.Google Scholar
Sullivan, C. E., Issa, F. G., Berthon-Jones, M., Eves, L. (1981) Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nose. Lancet 1: 862865.Google Scholar