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Cited by 97Obstructive Sleep Apnea ResearchRespiratory Support and MechanismsSleep and related disorders

Humidified nasal continuous positive airway pressure in obstructive sleep apnoea

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Neill, A.M., Wai, H.S., Bannan, S.P.T., Beasley, C.R., Weatherall, M., Campbell, A.J.·2003·European Respiratory Journal
DOI 10.1183/09031936.03.00035603
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Abstract

Heated humidification of nasal continuous positive airway pressure (nCPAP) reduces upper airway symptoms and improves initial use in obstructive sleep apnoea syndrome (OSAS). The present study aimed to assess the effect of heated humidification of nCPAP on upper airway symptoms and initial use in obstructive sleep apnoea. This study was of a randomised, crossover design. Subjects with polysomnographically confirmed OSAS were randomised to 3 weeks nCPAP treatment with heated humidification (nCPAP-humid) or placebo humidification (nCPAP pl-humid). Objective and subjective nCPAP use, upper airway symptoms, and treatment satisfaction were compared. Thirty seven of 42 patients completed the protocol. nCPAP-humid reduced the frequency of adverse upper airway symptoms. nCPAP use over 3 weeks was greater with nCPAP-humid compared with nCPAP pl-humid. No difference was found between the treatment arms in terms of subjective treatment satisfaction or alertness. Heated humidification of nasal continuous positive airway pressure reduces upper airway symptoms and is associated with a small increase in initial use but not subjective sleepiness or treatment satisfaction. The results support the use of heated humidification as a strategy to reduce side-effects related to continuous positive airway pressure but not routine initial use.

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Crossref · 10.1183/09031936.03.00035603

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  • Meta-analyses of 2 RCTs demonstrated clinically significant reduction in the odds of nasal discharge, dry nose, epistaxis, and dry mouth/throat with the use of humidified PAP while meta-analyses of 3 RCTs demonstrated clinically significant reduction in the odds of nasal congestion and dry mouth with the use of humidified PAP.

    “Meta-analyses of 2 RCTs 260,262 demonstrated clinically significant reduction in the odds of nasal discharge, dry nose, epistaxis, and dry mouth/throat with the use of humidified PAP while meta-analyses of 3 RCTs 260,262,263 demonstrated clinically significant reduction in the odds of nasal congestion and dry mouth with the use of humidified PAP (see supplemental material, Figure S102 through”

    From Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment (2019) · cites this paper as [260]

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  • Another study reported clinically significant reductions in the incidence of sinus pain/headache, sore throat, hoarse voice, and smell with odds ratios of 0.4 (95% CI: 0.1 to 1.4), 0.3 (95% CI: 0.1 to 1.6), 0.8 (95% CI: 0.2 to 3.2), and 0.7 (95% CI: 0.2 to 2.3) with humidification, respectively.

    “Another study reported clinically significant reductions in the incidence of sinus pain/headache, sore throat, hoarse voice, and”

    From Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment (2019) · cites this paper as [260]

    Table 3 (Discussion; page unavailable) shows lower symptom frequencies with heated humidification for all four named symptoms, and the Discussion describes the overall effect as clinically relevant. However, the table does not report the four odds ratios or confidence intervals quoted in the claim; it reports different values, and the individual symptom differences did not reach statistical significance. (LLM, conf=0.89)

    Experimental — accuracy not yet measured

  • This study reported no clinically significant differences in cough or sinus infection.

    “However, this study reported no clinically significant differences in cough or sinus infection.260”

    From Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment (2019) · cites this paper as [260]

    Table 3 reports identical sinus-infection frequencies in the two treatment arms (14% each) and a nonsignificant difference in cough (31% versus 24%; p=0.48). The Discussion says individual symptom differences did not reach statistical significance, but it does not establish that a clinically meaningful difference in cough was absent. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • A total of 9 RCTs were identified that evaluated the use of PAP with humidification versus PAP without humidification to improve one or more of the following outcomes: adherence to PAP therapy, sleepiness, QOL, or PAP-related side effects including nasal discharge, nasal congestion, dry nose, epistaxis, and dry mouth/throat.

    “A total of 9 RCTs were identified that evaluated the use of PAP with humidification versus PAP without humidification to improve one or more of the following outcomes: adherence to PAP therapy, sleepiness, QOL, or PAP-related side effects including nasal discharge, nasal congestion, dry nose, epistaxis, and dry mouth/throat.[258][259][260][261][262][263][264][265][266]”

    From Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment (2019) · cites this paper as [260]

  • Five studies reported on participant preference or satisfaction with the use of humidification, with participants on average either preferring heated humidification or expressing no clear preference for heated humidification.

    “Five studies [259][260][261][262]264 reported on participant preference or satisfaction with the use of humidification, with participants on average either preferring heated humidification 260,264 or expressing no clear preference 261,262 for heated humidification.”

    From Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment (2019) · cites this paper as [260]

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Authors
Neill, A. M., Wai, H. S., Bannan, S. P. T., Beasley, C. R., Weatherall, M., & Campbell, A. J.
Affiliations
  • University of Otago (NZ)
  • Victoria University of Wellington (NZ)
ORCID
Venue
European Respiratory Journal
Publisher
European Respiratory Society (ERS)
Published
2003-08
Volume
22
Issue
2
Pages
258-262
ISSN
  • 0903-1936 (ISSN-L)
  • 1399-3003
DOI
10.1183/09031936.03.00035603
OpenAlex
W2105443172
Semantic Scholar
9e727630907f04bcab5a49c87929941446d74d56
Cited by
97
References
32
Citations by year
2026: 1 · 2024: 3 · 2023: 5 · 2022: 5 · 2021: 1 · 2020: 2 · 2019: 5 · 2018: 7 · 2017: 3 · 2016: 7 · 2015: 3 · 2014: 3 · 2013: 4 · 2012: 2
FWCI
2.18
Type
journal article
Language
en
Open access
Locations
  • European Respiratory Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
heated humidification, nasal continuous positive airway pressure, obstructive sleep apnea, upper airway symptoms, treatment satisfaction, sleepiness, CPAP side effects
MeSH terms
Adult, Aged, Female, Hot Temperature, Humans, Humidity, Disorders of Excessive Somnolence, Male, Middle Aged, Treatment Outcome, Patient Satisfaction, Polysomnography, Cross-Over Studies, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure

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