title: Predictive factors for the need for additional humidification during nasal continuous positive airway pressure therapy.
abstract: OBJECTIVE
  To identify potential risk factors for the need for an additional cold or heated humidifier in nasal continuous positive airway pressure (nCPAP) circuitry.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  University hospital sleep-disorders center.
  
  
  METHODS
  Eighty-two consecutive patients with obstructive sleep apnea syndrome were followed up for a median of 347 days (range, 3 to 530 days) after the initiation of nCPAP therapy.
  
  
  RESULTS
  In 46 patients (56%), the occurrence of upper-airway symptoms led to the addition of a cold humidifier after a median time of 39 days (range, 2 to 94 days). In 23 of the 46 patients, the persistence of the symptoms indicated the secondary use of a heated humidifier after a median time of 28 days (range, 5 to 70 days). nCPAP use (mean +/- SD) was not influenced by cold humidification (4.58 +/- 2.05 h/d vs 4.7 +/- 2.48 h/d; p = 0.75), but it increased significantly with heated humidification (5.38 +/- 2.26 h/d vs 3.51 +/- 2.53 h/d; p < 0.01). Anthropometric characteristics, drying medications, clinical findings such as deformity of the nasal septum, symptoms of a chronic mucosa disease (CMD), a previous uvulopalatopharyngoplasty (UPPP), and polysomnographic parameters had no significant effect on the need for a cold humidifier. Age > 60 years (odds ratio [OR], 5.58; 95% confidence interval [CI], 1.69 to 18.43), drying medications (OR, 6.59; 95% CI, 1.29 to 33.51), presence of CMD (OR, 4.11; 95% CI, 1.24 to 13.58), and previous UPPP (OR, 4.56; 95% CI, 1.18 to 17.6) were found as significant risk factors for the addition of a heated humidifier.
  
  
  CONCLUSIONS
  Our results demonstrate that heated humidification significantly improves the nCPAP daily rate of use and that its need may be predicted.
authors.affiliation: Unité de Sommeil, Service de Pneumologie, Hôpital Saint Antoine, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Rakotonanahary
authors.forename: N
authors.initials: N
authors.lastname: Pelletier-Fleury
authors.forename: F
authors.initials: F
authors.lastname: Gagnadoux
authors.forename: B
authors.initials: B
authors.lastname: Fleury
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D006813:Humidity; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000628:therapy*