title: Nasal insufflation treatment adherence in obstructive sleep apnea.
abstract: BACKGROUND
  Nasal insufflation (NI) is a novel treatment method that has been introduced for improving respiration during sleep. NI’s warmed and humidified nasal airflow provides ventilatory assistance delivered as a rapidly dispersed pressure head, with minimal side wall pressures, that may affect treatment tolerability. The aim of the current study was to investigate objective and subjective adherence rates for NI therapy in mild to moderate obstructive sleep apnea (OSA).
  
  
  METHODS
  Ten patients (three men and seven women; age, 51.3 ± 9.6 years; BMI, 32.2 ± 7.7 kg/m2 [mean ± sd]) with recently diagnosed mild to moderate OSA (10.9 ± 5.8 events/h) were investigated. A crossover design was used to compare adherence to NI and continuous positive airway pressure (CPAP) therapy using a range of objective and subjective measurements. Objective (sleep efficiency (%) and arousal indices (arousal/h)) and subjective evaluations of sleep quality were carried out each night in the laboratory. During in-home treatment, adherence for both therapies was assessed objectively (time on therapy) and subjectively (self-reported sleep diary).
  
  
  RESULTS
  Objectively derived adherence values were comparable for CPAP and NI, with both treatment devices sharing similar usage per night (3.5 ± 2.5 vs. 3.6 ± 1.6 h/night; respectively) and the number of nights with at least 4 h of treatment (5.5 ± 4.3 vs. 6.8 ± 3.3 nights/trial, respectively). Self-reported adherence was significantly higher than objectively assessed adherence (p < 0.03).
  
  
  CONCLUSIONS
  This study showed similar adherence to NI and CPAP over a short period of usage. A randomized clinical trial is now essential for determining the comparative effectiveness of NI therapy in relation to treatment with CPAP.
authors.forename: Mudiaga O
authors.initials: MO
authors.lastname: Sowho
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Woods
authors.forename: Paolo
authors.initials: P
authors.lastname: Biselli
authors.forename: Brian M
authors.initials: BM
authors.lastname: McGinley
authors.forename: Luis F
authors.initials: LF
authors.lastname: Buenaver
authors.forename: Jason P
authors.initials: JP
authors.lastname: Kirkness
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D045422:Continuous Positive Airway Pressure / Q000523:psychology*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007327:Insufflation / Q000295:instrumentation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D017286:Polysomnography / Q000295:instrumentation; D012138:Respiratory Therapy / Q000295:instrumentation / Q000523:psychology*; D020181:Sleep Apnea, Obstructive / Q000523:psychology* / Q000628:therapy*