title: Rates of initial acceptance of PAP masks and outcomes of mask switching.
abstract: OBJECTIVE
  Recently, we noticed a considerable development in alleviating problems related to positive airway pressure (PAP) masks. In this study, we report on the initial PAP mask acceptance rates and the effects of mask switching on mask-related symptoms.
  
  
  METHODS
  We prospectively collected all cases of mask switching in our sleep unit for a period of 14 months. At the time of the study, we used ResMed™ CPAP devices and masks. Mask switching was defined as replacing a mask used for at least 1 day with another type of mask. Changing to a different size but keeping the same type of mask did not count as mask switching. Switching outcomes were considered failed if the initial problem persisted or reappeared during the year that followed switching.
  
  
  RESULTS
  Our patient pool was 2768. We recorded 343 cases of mask switching among 267 patients. Of the 566 patients who began new PAP therapy, 108 (39 women) had switched masks, yielding an initial mask acceptance rate of 81 %. The reason for switching was poor-fit/uncomfortable mask in 39 %, leak-related in 30 %, outdated model in 25 %, and nasal stuffiness in 6 % of cases; mask switching resolved these problems in 61 %. Mask switching occurred significantly (p = 0.037) more often in women and in new PAP users. The odds ratio for abandoning PAP therapy within 1 year after mask switching was 7.2 times higher (interval 4.7-11.1) than not switching masks.
  
  
  CONCLUSIONS
  The initial PAP mask acceptance rate was high. Patients who switched their masks are at greater risk for abandoning PAP therapy.
authors.affiliation: Sleep Unit, Heart and Lung Centre, Helsinki University Hospital, University of Helsinki, P.O. Box 160, 00029, HUS, Finland. adel.bachour@hus.fi.
authors.forename: Adel
authors.identifier: http://orcid.org/0000-0002-7367-6613
authors.initials: A
authors.lastname: Bachour
authors.affiliation: Sleep Unit, Heart and Lung Centre, Helsinki University Hospital, University of Helsinki, P.O. Box 160, 00029, HUS, Finland.
authors.forename: Pirjo
authors.initials: P
authors.lastname: Vitikainen
authors.affiliation: Sleep Unit, Heart and Lung Centre, Helsinki University Hospital, University of Helsinki, P.O. Box 160, 00029, HUS, Finland.
authors.forename: Paula
authors.initials: P
authors.lastname: Maasilta
mesh_terms: D000328:Adult; D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008397:Masks; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D010352:Patient Dropouts; D017286:Polysomnography; D011446:Prospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000628:therapy*
keywords: CPAP interface; Mask switching; Outcomes; Side effects; Sleep apnea