title: Oronasal masks require higher levels of positive airway pressure than nasal masks to treat obstructive sleep apnea.
abstract: OBJECTIVE
  The purpose of this study was to compare the therapeutic pressure determined by an automated CPAP device (AutoCPAP) during the titration period, between nasal and oronasal mask and the residual apnea-hypopnea index (AHI) on a subsequent poligraphy performed with the established therapeutic CPAP.
  
  
  METHODS
  As a retrospective study, 109 subjects with moderate and severe obstructive sleep apnea-hypopnea (apnea-hypopnea index≥15 events/h) were studied. CPAP titration was performed using an auto-titrating device.
  
  
  RESULTS
  There was significant difference in the mean pressure delivered with autoCPAP between the group of patients using the nasal mask (mean 10.0 cmH2O±2.0 SD) and the group which used the oronasal mask (mean 11.2 cmH2O±2.1) (p<0.05). Residual apneas were lower when using a nasal mask: average AHI of 2.6±2.5 compared to 4.5±4.0 using an oronasal mask (p<0.05). On multivariate analysis, the only independent predictor of the level of therapeutic pressure of CPAP was the type of mask used (r=0.245, p 0.008).
  
  
  CONCLUSIONS
  Therapeutic CPAP level for OSAH is higher when administered via oronasal mask, leaving more residual events. These findings suggest that nasal mask should be the first choice for OSAH treatment.
authors: Cattedra di Malattie dell'Apparato Respiratorio, Università di Brescia, Brescia, Italy.
authors: Michela
authors: M
authors: Bettinzoli
authors: Luigi
authors: L
authors: Taranto-Montemurro
authors: Ludovico
authors: L
authors: Messineo
authors: Luciano
authors: L
authors: Corda
authors: Stefania
authors: S
authors: Redolfi
authors: Mauro
authors: M
authors: Ferliga
authors: Claudio
authors: C
authors: Tantucci
mesh_terms: D000328:Adult; D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008397:Masks; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation; D017286:Polysomnography / Q000295:instrumentation; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D013813:Therapy, Computer-Assisted / Q000295:instrumentation*