When patients with obstructive sleep apnea begin treatment with continuously positive airway pressure, adherence can be challenging. CPAP-treatment is quite effective, but unfortunately it is also poorly tolerated, often due to side effects and the type of mask used. Common side effects are unintended leakage, pressure ulcers, rhinitis, conjunctivitis, upper airway collapse and claustrophobia. Side effects occurs more frequently when the treatment pressure is increased. The last decade has provided us with a wide selection of different masks; nasal masks, oronasal masks, masks covering the entire face, prongs, oral masks and even masks made from textiles.
The study Oronasal vs Nasal Masks by Landry et al. published in Chest last year brings new insight into the mechanism and the effect different masks have on the collapse of the upper airways. They conclude that an oralnasalmask are associated with an increased apnea-hypopnea index and therefore demands higher treatment pressures. This may cause side effects and affect adherence negatively.
Recommended article in the field of long-term noninvasive ventilation and CPAP-treatment:
Oronasal vs Nasal Masks. The Impact of Mask Type on CPAP Requirement, Pharyngeal Critical Closing Pressure (Pcrit), and Upper Airway Cross-Sectional Areas in Patients With OSA
The full article is available here: https://doi.org/10.1016/j.chest.2023.03.025
