Oronasal mask may compromise the efficacy of continuous positive airway pressure on OSA treatment: is there evidence for avoiding the oronasal route?

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art_ANDRADE_Oronasal_mask_may_compromise_the_efficacy_of_continuous_2016.PDF (530.09 KB)
Citações na Scopus
18
Tipo de produção
article
Data de publicação
2016
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
LIPPINCOTT WILLIAMS & WILKINS
Autores
Citação
CURRENT OPINION IN PULMONARY MEDICINE, v.22, n.6, p.555-562, 2016
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Purpose of review Continuous positive airway pressure (CPAP) delivered by nasal mask is the gold standard treatment for obstructive sleep apnea (OSA). However, oral and oronasal masks are also available. We considered experimental evidence and reviewed clinical trials that evaluated the impact of oral and oronasal mask on OSA treatment. Recent findings One recent study in 18 OSA patients that slept with a customized oronasal mask with two sealed compartments showed that the change of CPAP flow from nasal to oronasal and oral caused upper airway obstruction because of posterior displacement of the tongue demonstrated by nasoendoscopy. Oral masks use a mouthpiece that may stabilize the jaw and the tongue and have shown to be effective. However, oral masks are not widely used in clinical practice. Four out of five observational studies and all five reviewed randomized studies showed a worse performance of oronasal when compared with nasal masks. Oronasal masks were associated with higher residual apnea-hypopnea index, lower adherence, more leaks, and less satisfaction than nasal mask in the majority of the studies. Summary Nasal CPAP must be the first choice to treat OSA. Patients on oronasal mask should be carefully followed.
Palavras-chave
continuous positive airway pressure, nasal mask, obstructive sleep apnea, oral mask, oronasal mask
URI
https://observatorio.fm.usp.br/handle/OPI/17282
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Coleções
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/09