Browsing by Subject "CPAP"

Sort by: Order: Results:

Now showing items 1-6 of 6
  • Elomaa, Timo (Helsingin yliopisto, 2018)
    Objective: There are few studies on the effect of Positive Airway Pressure (PAP) therapy on eye symptoms in sleep apnea patients and the conclusions of these studies are inconsistent. We evaluated by questionnaire, possible changes in eye symptoms with PAP therapy. Methods: Consecutive sleep apnea patients referred for PAP initiation were asked about their eye symptoms at baseline, four days and two months of PAP therapy. We used a Visual Analog Scale. Zero value means no symptoms, whereas a value of 100 indicates severe eye dryness or severe eye watering. During a PAP preparation session, a sleep nurse tried to choose the most suitable mask interface for a good mask seal and to avoid eventual air leak toward the eyes. Results: We included 46 patients (14 women) with a mean age 56.0 ± 15.9, BMI 31.7 ± 6.0, apnea and hypopnea index 34.1 ± 21.8. No significant changes in dry eye symptom values at baseline (27.5 ± 26.6) compared to four days (28.7 ± 26.0) or two months (30.0 ± 28.2) of PAP therapy were observed. Eye watering values also showed absence of significant changes with PAP therapy. Five patients discontinued PAP therapy within two months; dry eye symptom and watering values at baseline in these patients did not differ from those who continued. Conclusions: When assuring a good individual PAP mask interface adjustment, short-term PAP therapy did not increase eye symptoms in sleep apnea patients. Patients who discontinued PAP had the same eye symptom values as those who continued beyond two months.
  • Kauppi, Paula; Bachour, Patrick; Maasilta, Paula; Bachour, Adel (2016)
    Both asthma and obstructive sleep apnoea cause sleep disturbance, daytime sleepiness and diminished quality of life. Continuous positive airway pressure (CPAP) is efficient in reducing symptoms related to sleep apnoea. Here we report the impact of long-term use of CPAP on asthma symptoms. A survey questionnaire was distributed to all of our obstructive sleep apnoea patients with CPAP therapy in 2013. We used the Finnish version of the Asthma Control Test (TM) (ACT) and a visual analogue scale (0 = no symptoms, 100 = severe asthma symptoms). Asthma was defined as self-reported physician-diagnosed disease and a special reimbursement for asthma medication by the Social Insurance Institution. We sent 2577 questionnaires and received 1586 answers (61 %). One hundred ninety-seven patients were asthmatics with a prevalence of asthma among CPAP users of 13 %. We studied 152 patients (58 females) whose CPAP therapy was initiated after starting asthma medication. Their mean (SD) age was 62 (10) years, duration of CPAP 5.7 (4.7) years and their CPAP daily use was 6.3 (2.4) h. Self-reported asthma severity decreased significantly from 48.3 (29.6) to 33.1 (27.4) (p <0.001), and ACT score increased significantly from 15.35 (5.3) to 19.8 (4.6) (p <0.001) without a significant change in the body mass index (BMI). The percentage of patients using rescue medication daily reduced from 36 to 8 % with CPAP (P <0.001). We noticed a significant decrease in asthma symptoms with long-term use of CPAP in patients with both asthma and obstructive sleep apnoea.
  • Bachour, Patrick; Bachour, Adel; Kauppi, Paula; Maasilta, Paula; Makitie, Antti; Palotie, Tuula (2016)
    There is an increasing tendency to use oral appliance (OA) as an alternative treatment for sleep apnea. Here we report the long-term adherence and clinical effects of OA therapy. All sleep apnea patients treated at the Department of Dentistry between the years 2006 and 2013 (n = 1208) were reviewed. A questionnaire about OA adherence, asthma symptoms (Asthma Control Test (TM), ACT), and general health was sent to all patients who continued OA therapy after the 1-month follow-up visit (n = 811). OA was adjusted to obtain at least 70 % of the maximal protrusion of the mandible. The response rate was 37.4 % (99 women, 204 men). The mean +/- SD age and BMI were 58.7 +/- 10.3 years and 27.3 +/- 4.0 kg/m(2), respectively. During the mean follow-up period of 3.3 years, there was no significant variation in BMI. Forty-one patients abandoned OA therapy yielding an adherence rate of 86 %. Ninety-seven percent of patients used OA a parts per thousand yen4 h/day, and the mean daily use was 7.2 +/- 1.1 h. The ACT score improved with OA use from 16.0 +/- 5.9 to 20.1 +/- 3.8 (p = 0.004), indicating better asthma control. The apnea and hypopnea index decreased significantly from 27 +/- 19 at baseline to 10 +/- 10 with OA therapy (p = 0.001). After a 1-month trial period, the long-term adherence to oral appliance was good. OA therapy decreased apneas and hypopneas significantly, and its long-term use was associated with an improvement in respiratory and asthma symptoms.
  • HAROSA II Study Grp; Dauvilliers, Yves; Verbraecken, Johan; Partinen, Markku; Pepin, Jean-Louis (2020)
    Rationale: Excessive daytime sleepiness is a common disabling symptom in obstructive sleep apnea syndrome. Objectives: To evaluate the efficacy and safety of pitolisant, a selective histamine H3 receptor antagonist with wake-promoting effects, for the treatment of daytime sleepiness in patients with moderate to severe obstructive sleep apnea refusing continuous positive airway pressure treatment. Methods: In an international, multicenter, double-blind, randomized (3:1), placebo-controlled, parallel-design trial, pitolisant was individually titrated at up to 20 mgld over 12 weeks. The primary endpoint was the change in the Epworth Sleepiness Scale score. Key secondary endpoints were maintenance of wakefulness assessed on the basis of the Oxford Sleep Resistance test, safety, Clinical Global Impression of severity, patient's global opinion, EuroQol quality-of-life questionnaire, and Pichot fatigue questionnaire. Measurements and Main Results: A total of 268 patients with obstructive sleep apnea (75% male; mean age, 52 yr; apnea-hypopnea index, 49/h; baseline sleepiness score, 15.7) were randomized (200 to pitolisant and 68 to placebo) and analyzed on an intention-to-treat basis. The Epworth Sleepiness Scale score was reduced more with pitolisant than with placebo (-2.8; 95% confidence interval, -4.0 to -1.5; P <0.001). Wake maintenance tests were not improved. The Pichot fatigue score was reduced with pitolisant. The overall impact of pitolisant was confirmed by both physicians' and patients' questionnaires. Adverse event incidence, mainly headache, insomnia, nausea, and vertigo, was similar in the pitolisant and placebo groups (29.5% and 25.4%, respectively), with no cardiovascular or other significant safety concerns. Conclusions: Pitolisant significantly reduced self-reported daytime sleepiness and fatigue and improved patient-reported outcomes and physician disease severity assessment in sleepy patients with obstructive sleep apnea refusing or nonadherent to continuous positive airway pressure.
  • HAROSA I Study Grp; Pepin, Jean-Louis; Georgiev, Ognian; Tiholov, Rumen; Partinen, Markku; Dauvilliers, Yves (2021)
    BACKGROUND: Excessive daytime sleepiness (EDS) in individuals with OSA syndrome persisting despite good adherence to CPAP is a disabling condition. Pitolisant is a selective histamine H3-receptor antagonist with wake-promoting effects. RESEARCH QUESTION: Is pitolisant effective and safe for reducing daytime sleepiness in individuals with moderate to severe OSA adhering to CPAP treatment but experiencing residual EDS? STUDY DESIGN AND METHODS: In a multicenter, double-blind, randomized (3:1), placebo-controlled, parallel-design trial, pitolisant was titrated individually at up to 20 mg/day and taken over 12 weeks. The primary end point was change in the Epworth Sleepiness Scale (ESS) score in the intention-to treat population. Key secondary end points were maintenance of wakefulness assessed by the Oxford Sleep Resistance Test, Clinical Global Impressions scale of severity, the patient's global opinion, EuroQoL quality-of-life questionnaire score, Pichot fatigue questionnaire score, and safety. RESULTS: Two hundred forty-four OSA participants (82.8% men; mean age, 53.1 years; mean Apnea Hypopnea Index with CPAP, 4.2/h; baseline ESS score, 14.7) were randomized to pitolisant (n = 183) or placebo (n = 61). ESS significantly decreased with pitolisant compared with placebo (-2.6; 95% CI, -3.9 to -1.4; P < .001), and the rate of responders to therapy (ESS # 10 or change in ESS $ 3) was significantly higher with pitolisant (71.0% vs 54.1%; P = .013). Adverse event occurrence (mainly headache and insomnia) was higher in the pitolisant group compared with the placebo group (47.0% and 32.8%, respectively; P = .03). No cardiovascular or other significant safety concerns were reported. INTERPRETATION: Pitolisant used as adjunct to CPAP therapy for OSA with residual sleepiness despite good CPAP adherence significantly reduced subjective and objective sleepiness and improved participant-reported outcomes and physician-reported disease severity.
  • Vuorjoki-Ranta, Tiina-Riitta; Aarab, Ghizlane; Lobbezoo, Frank; Tuomilehto, Henri; Ahlberg, Jari (2019)
    Purpose The aim was to analyze whether or not weight gain influences the treatment outcome of patients with obstructive sleep apnea (OSA) treated with mandibular advancement devices (MAD). Methods As a part of a follow-up study among OSA patients treated with MAD in primary oral health care, a group of 28 patients reporting worsening of daytime or nighttime symptoms of OSA was given closer examination. Altogether, 21 subjects had a complete set of recordings and were enrolled into the study. Results Only three subjects had lost weight during the study period. The mean weight gain of 3.6kg7.1kg was significant (p=0.035). According to linear regression, weight gain was independently significantly associated with lower mean peripheral oxygen saturation 92.4 (SD 1.8 (% per hour) (p=0.019)) and lowest oxygen saturation 80.1 (SD 7.2 (%) (p=0.024)) scores. Conclusions Weight gain is detrimentally associated with MAD treatment in patients with OSA. These findings suggest that regular follow-up by an experienced dentist is advisable to assess for possible worsening of OSA. Patient support to encourage weight control may be an important adjunct to MAD treatment for OSA.