title: Initiation of CPAP therapy for OSA: does prophylactic humidification during CPAP pressure titration improve initial patient acceptance and comfort?
abstract: BACKGROUND
  Heated humidifiers (HH) enable effective treatment of upper airway dryness during nasal continuous positive airway pressure (nCPAP) therapy for obstructive sleep apnoea (OSA), but the role of prophylactic use of HH during the initiation of nCPAP treatment has not been studied so far.
  
  
  OBJECTIVE
  The aim of the present study was to investigate whether prophylactic HH during the initiation of CPAP would result in improved initial patient comfort and acceptance.
  
  
  METHODS
  In 44 consecutive, previously untreated OSA patients with no history of upper airway dryness, CPAP titration with and without HH was performed on two consecutive nights in a randomised order. The patients were interviewed after each treatment night in order to establish the comfort of the treatment, and, after the second treatment, they were asked which of the two nights they considered more pleasant, and which treatment they would prefer for long-term use.
  
  
  RESULTS
  Following CPAP titration with HH, 32 patients (73%) claimed to have had a better night's sleep than usual (i.e. without CPAP treatment) compared with 33 patients (75%) saying the same following CPAP treatment without HH. For 21 patients (47.7%) treatment with HH was more pleasant, 23 (52.3%) saw no difference or said that treatment without HH was more pleasant. Nineteen patients (43.2%) gave preference to treatment with HH for long-term use, while 25 patients (56.8%) had no preference or said they would prefer treatment without HH.
  
  
  CONCLUSIONS
  The use of HH during the initiation phase of CPAP treatment was associated neither with an initial improvement in comfort nor with greater initial treatment acceptance.
authors.affiliation: Medical Department I, University of Erlangen-Nuremberg, Germany. gunther.wiest@med1.imed.uni-erlangen.de
authors.forename: G H
authors.initials: GH
authors.lastname: Wiest
authors.forename: I A
authors.initials: IA
authors.lastname: Harsch
authors.forename: F S
authors.initials: FS
authors.lastname: Fuchs
authors.forename: S
authors.initials: S
authors.lastname: Kitzbichler
authors.forename: K
authors.initials: K
authors.lastname: Bogner
authors.forename: W M
authors.initials: WM
authors.lastname: Brueckl
authors.forename: E G
authors.initials: EG
authors.lastname: Hahn
authors.forename: J H
authors.initials: JH
authors.lastname: Ficker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D006813:Humidity; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000379:methods*; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D011795:Surveys and Questionnaires