Journal Information
Vol. 39. Issue 3.
Pages 106-110 (March 2003)
Share
Share
Download PDF
More article options
Vol. 39. Issue 3.
Pages 106-110 (March 2003)
Full text access
Resistencia nasal y tratamiento con presión positiva continua en la vía aérea en el síndrome de apnea-hipopnea obstructiva del sueño
Nasal resistance and continuous positive airway pressure treatment for sleep apnea/hypopnea syndrome
Visits
9270
J. Tárregaa, M. Mayosa,
Corresponding author
mmayos@hsp.santpau.es

Correspondencia: Departament de Pneumologia. Hospital de la Sta. Creu i de Sant Pau.Avda. Sant Antoni Maria Claret, 167. 08025 Barcelona. España
, J.R. Montserratb, J.M. Fabrab, F. Morantea, A. Cáliza, J. Sanchisa
a Departamento de Neumología. Hospital de la Santa Creu i de Sant Pau. Barcelona
b Servicio de ORL. Hospital de la Santa Creu i de Sant Pau. Barcelona. España
This item has received
Article information
Objetivo

Evaluar la relación de la resistencia nasal (RN) con la tolerancia y el cumplimiento del tratamiento con pre-sión positiva continua en la vía aérea (CPAP) en pacientes con síndrome de apnea-hipopnea obstructiva del sueño (SAHS)

Material y método

Se estudió a 125 pacientes con índice de apneas-hipopneas (IAH) media (desviación típica) de 53 ± 21, en tratamiento con CPAP. La RN fue medida antes de iniciar el tratamiento mediante rinomanometría anterior ac-tiva, considerando los valores de flujo (ml/s) a 150 Pa de presión en cada fosa nasal. Se valoró la tolerancia y el cum-plimiento de la CPAP a las 2 semanas, a los 6 meses y al año del tratamiento

Resultados

La media de la presión de CPAP prescrita fue de 9 ± 2cmH2O. En 70 pacientes (56%) se consideró que la rinomanometría era patológica. No observamos correla-ción entre los flujos nasales y la presión de CPAP estableci-da (r=0,018). El cumplimiento objetivo del tratamiento en el primer año fue de 5 ± 1,5 h/día. En este período, los efec-tos secundarios nasales más frecuentes fueron síntomas fun-cionales, tales como hidrorrinorrea, picor o estornudos (24%), sequedad oronasal (21%) y obstrucción nasal subje-tiva (6%). No hubo diferencias significativas en la tolerancia y el cumplimiento de la CPAP entre los pacientes con rino-manometrías normal y patológica

Conclusiones

En el paciente con SAHS, la RN valorada con rinomanometría anterior no se correlaciona con el nivel de presión óptima de CPAP y no influye en su tolerancia ni en su cumplimiento

Palabras clave:
Síndrome de apnea-hipopnea obstructiva del sue-ño
Presión positiva continua de la vía aérea
Resistencia nasal
Objective

To evaluate the relation between nasal resis-tance and tolerance and compliance with continuous positi-ve airway pressure (CPAP) in patients with obstructive sle-ep apnea/hypopnea syndrome (SAHS)

Material and method

One hundred twenty-five patients with a mean apnea/hypopnea index (AHI) of 53 ± 21 were assessed for nasal resistance by active anterior rhinometry before starting CPAP treatment. Airflow (cm 3 /s) at 150 Pa was measured at each nostril. Tolerance for and compliance with CPAP was assessed at 2 weeks, 6 months and one year after start of treatment

Results

The mean CPAP prescribed was 9 ± 2cmH2O. Rhinometry findings were considered pathological for 70 patients (56%). We observed no correlation between nasal flow and the CPAP established (r=0.018). The treatment compliance objective in the first year was 5 ± 1.5 hours/day. The most common nasal side effects during this period were runny nose, itching and sneezing (24%), oronasal dryness (21%) and subjective nasal obstruction (6%). There were no significant differences in tolerance of or compliance with CPAP treatment between patients with normal or abnormal rhinometry

Conclusions

Nasal resistance assessed by anterior rhino-metry is unrelated to optimum CPAP and does not affecteither tolerance or compliance among patients with SAHS

Keywords:
Sleep apnea/hypopnea syndrome
Continuous positi-ve airway pressure
Nasal resistance
Full text is only aviable in PDF
Bibliografía
[1.]
R.E. Waldhorn, T.W. Herrick, M.C. Nguyen, A.E. O'Donnell, J. Sodero, S.J. Potolicchio.
Long-term compliance with nasal continuous positive airway pressure therapy of obstructive sleep apnea.
Chest, 97 (1990), pp. 33-38
[2.]
J. Krieger.
Long-term compliance with nasal continuous positive airway pressure (CPAP) in obstructive sleep apnea patients and nonapneic snorers.
Sleep, 15 (1992), pp. S42-S46
[3.]
V. Hoffstein, S. Viner, S. Mateika, J. Conway.
Treatment of obstructive sleep apnea with nasal continuous positive airway pressure: patient compliance, perception of benefits and side effects.
Am Rev Respir Dis, 145 (1992), pp. 841-845
[4.]
H.M. Engleman, S.E. Martin, N.J. Douglas.
Compliance with CPAP therapy in patients with the sleep apnoea/hypopnea syndrome.
Thorax, 49 (1994), pp. 263-266
[5.]
J.L. Pepin, P. Leger, D. Vale, B. Langevin, R. Dominique, P. Levy.
Side effects of nasal continuous positive airways pressure in sleep apnea syndrome: study of 193 patients in two french sleep centers.
Chest, 107 (1995), pp. 375-381
[6.]
H.M. Engleman, N. Asgari-Jirhandeh, A.L. McLeod, C.F. Ramsay, I.J. Deary, N.J. Douglas.
Self-reported use of CPAP and benefits of CPAP therapy. A patient survey.
Chest, 109 (1996), pp. 1470-1476
[7.]
T.H. Pieters, P.H. Collard, G. Aubert, M. Dury, P. Delguste, D.O. Rodenstein.
Acceptance and long-term compliance with nCPAP in patients with obstructive sleep apnoea syndrome.
Eur J Respir J, 9 (1996), pp. 939-944
[8.]
M. Meslier, T. Lebrun, V. Grillier-Lanoir, N. Rolland, C. Henderick, J.C. Sailly, et al.
A French survey of 3225 patients treated with CPAP for obstructive sleep apnoea: benefits, tolerance, compliance and quality of life.
Eur Respir J, 12 (1998), pp. 185-192
[9.]
N. McArdle, G. Devereux, H. Heidarnejad, H.M. Engleman, T.W. Mackay, N.J. Douglas.
Long term use of CPAP therapy for sleep apnea/ hypopnea syndrome.
Am J Respir Crit Care Med, 159 (1999), pp. 1108-1114
[10.]
P. Howard, J.C. Waterhouse, C.G. Billing.
Compliance with longterm oxygen therapy by concentrator.
Eur Respir J, 5 (1992), pp. 128-129
[11.]
R.R. Grunstein.
Nasal continous positive airway pressure treatment for obstructive sleep apnea.
Thorax, 50 (1995), pp. 1106-1113
[12.]
J.M. Montserrat, J. Amilibia, F. Barbe, F. Capote, J. Durán, N.G. Mangado, et al.
Tratamiento del síndrome de apnea-hipopnea obstructiva del sueño.
Arch Bronconeumol, 34 (1998), pp. 204-206
[13.]
J.M. Fabra.
Rinomanometría anterior activa [tesis doctoral],
[14.]
T. Young, L. Finn, H. Kim.
Nasal obstruction as a risk factor for sleep-disordered breathing. The University of Wisconsin Sleep and Respiratory Research group.
J Allergy Clin Immunol, 99 (1997), pp. S757-S762
[15.]
M. Atkins, V. Taskar, N. Clayton, P. Stone, A. Woodcork.
Nasal resistance in obstructive sleep apnoea.
Chest, 105 (1994), pp. 1133-1135
[16.]
H. Miljeteig, P. Savard, S. Mateika, P. Cole, J.S. Haight, V. Hoffstein.
Snoring and nasal resistance during sleep.
Laringoscope, 103 (1993), pp. 918-923
[17.]
H. Miljeteig, V. Hoffstein, P. Cole.
The effect of unilateral and bilateral nasal obstruction on snoring and sleep apnoea.
Laringoscope, 102 (1992), pp. 1150-1152
[18.]
N. Mirza, D.C. Lanza.
The nasal airway and obstructed breathing during sleep.
Otolaryngol Clin North Am, 32 (1999), pp. 243-262
[19.]
F. Series, S. St. Pierre, G. Carrier.
Effects of surgical correction of nasal obstruction in the treatment of obstructive sleep apnea.
Am Rev Respir Dis, 146 (1992), pp. 1261-1265
[20.]
J. Lojander, P.E. Brander, K. Ämmälä.
Nasophariyngeal symptoms and nasal continuous positive airway pressure therapy in obstructive sleep apnoea syndrome.
Acta Otolaryngol (Stockh), 119 (1999), pp. 497-502
[21.]
C. Janson, E. Noges, S. Svedberg-Randt, E. Lindberg.
What characterizes patients who are unable to tolerate continuous positive airway pressure (CPAP) treatment?.
Respir Med, 94 (2000), pp. 145-149
[22.]
G.N. Richards, P.A. Cistulli, G. Ungar, M. Berthon-Jones, C.E. Sullivan.
Mouth leak with nasal continuous positive airway pressure increase nasal airway resistance.
Am J Respir Crit Care Med, 154 (1996), pp. 182-186
[23.]
M.T. Martins, S. Barros, E. Corral, B. Fleury.
Heated humidification or face mask to prevent upper airway dryness during continuous positive airway pressure theraphy.
Chest, 117 (2000), pp. 142-147
[24.]
P. Cole, J.S. Haight.
Posture and the nasal cicle.
Ann Otol Rhinol Laryngol, 95 (1986), pp. 233-237
[25.]
P. Cole, J.S. Haight.
Mechanisms of nasal obstruction in sleep.
Laringoscope, 94 (1984), pp. 1557-1559
[26.]
P. Desfonds, C. Planès, C. Fuhrman, A. Fouches, B. Raffestin.
Nasal resistance in snorers with or without sleep apnea: Effect of posture and nasal ventilation with continuous positive airway pressure.
Sleep, 21 (1998), pp. 625-632
Copyright © 2003. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?