title: Frequency of upper airway symptoms before and during continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome.
abstract: BACKGROUND
  Upper airway side effects are common during nasal continuous positive airway pressure (nCPAP) treatment and may affect the use of nCPAP.
  
  
  OBJECTIVE
  It was our aim to evaluate the prevalence of upper airway symptoms in obstructive sleep apnea syndrome (OSAS) patients before and during nCPAP treatment and to assess the possible association between the symptoms and long-term adherence to the treatment.
  
  
  METHODS
  We examined 385 consecutive OSAS patients (79% men, mean age ± SD 52 ± 10 years and apnea-hypopnea index 33 ± 23) by means of a prospective questionnaire-based survey. The patients filled in questionnaires about upper airway symptoms before starting nCPAP and after 2 months of treatment.
  
  
  RESULTS
  Upper airway symptoms were common before starting nCPAP: 61% of the patients reported dryness of mouth, 54% dryness of throat, 52% nasal stuffiness, 51% dryness of nose, 30% sneezing, 24% mucus in throat, 17% rhinorrhea, and 6% nose bleeds daily or almost daily. In CPAP users there was a significant decline in the number of patients with frequent mouth (37%), throat (34%), nose (28%) dryness and nasal stuffiness (24%). There was no difference in upper airway symptoms before nCPAP treatment between those who continued the treatment after 1 year and those who terminated the treatment.
  
  
  CONCLUSIONS
  The most common upper airway symptoms in patients with untreated OSAS seem to be associated with mucosal dryness. These symptoms improved during nCPAP treatment probably due to the change in breathing pattern. The occurrence of upper airway symptoms before nCPAP start did not predict long-term adherence to the treatment.
authors.affiliation: Division of Pulmonary Diseases, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. hanna-riikka.kreivi@fimnet.fi
authors.forename: Hanna-Riikka
authors.initials: HR
authors.lastname: Kreivi
authors.forename: Paula
authors.initials: P
authors.lastname: Virkkula
authors.forename: Juho
authors.initials: J
authors.lastname: Lehto
authors.forename: Pirkko
authors.initials: P
authors.lastname: Brander
mesh_terms: D000328:Adult; D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009668:Nose Diseases / Q000209:etiology*; D010349:Patient Compliance; D010608:Pharyngeal Diseases / Q000209:etiology*; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000628:therapy*; D011795:Surveys and Questionnaires