Heated humidification during nasal continuous positive airway pressure for obstructive sleep apnea syndrome: objective evaluation of efficacy with nasal peak inspiratory flow measurements.
BACKGROUND
Nasal obstruction is one of the most frequent and sometimes troublesome side effects of nasal continuous positive airway pressure (nCPAP) therapy for obstructive sleep apnea syndrome (OSAS).


METHODS
We describe a 60-year-old man with allergic seasonal rhinitis and OSAS, with worsening nasal symptoms 1 week after beginning home nCPAP, making nCPAP use difficult (nasal peak inspiratory flow [nPIF], 80 L/minute [57% of his best]).


RESULTS
No significant improvement was obtained with topical steroids or cold humidification. Heated humidification was then considered, achieving an improvement in mean nPIF and symptom scores. An acceptable compliance with CPAP could be obtained during the heated humidification period (3.9 hours of mean daily use).


CONCLUSIONS
In this patient with moderately severe OSAS and allergic rhinitis, monitoring nasal symptoms and nasal PIF objectively showed the benefit of heated humidification to overcome nasal intolerance and increase compliance to nCPAP treatment.
Department of Pneumology, Faculty of Medicine, Hospital de S João, Porto, Portugal.
João C
JC
Winck
J Luís
JL
Delgado
João M
JM
Almeida
José A
JA
Marques
D000403:Airway Resistance; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006358:Hot Temperature; D006801:Humans; D006813:Humidity; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods; D011175:Positive-Pressure Respiration / Q000379:methods; D012129:Respiratory Function Tests; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D018570:Risk Assessment; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome