title: Factors Contributing to Unintentional Leak During CPAP Treatment: A Systematic Review.
abstract: CPAP is the first-line treatment for moderate to severe OSA syndrome. Up to 25% of patients with OSA syndrome discontinue CPAP treatment due to side effects. Unintentional leakage and its associated annoying consequences are the most frequently reported adverse effects of CPAP. Successive technological improvements have not succeeded in addressing this issue. A systematic review was conducted (1) to assess the impact of different technological advances on unintentional leaks and (2) to determine if any patient characteristics have already been identified as determinants of unintentional leakage. No CPAP modality was superior to another in reducing unintentional leaks and, surprisingly, oronasal masks were associated with higher unintentional leaks. Nasal obstruction, older age, higher BMI, central fat distribution, and male sex might be associated with an increased risk of unintentional leakage. Such leaks remain an important problem. Further studies are needed to improve the understanding of underlying clinical factors so that patients at risk of unintentional leaks may be identified and individualized solutions applied.
authors.affiliation: Department of Research and Development, Association AGIR à dom, HP2 Laboratory, INSERM U 1042, Meylan, France. Electronic address: mariuslebret@gmail.com.
authors.forename: Marius
authors.initials: M
authors.lastname: Lebret
authors.affiliation: CHU UCL, Site Sainte Elisabeth, Namur, Belgium.
authors.forename: Jean-Benoit
authors.initials: JB
authors.lastname: Martinot
authors.affiliation: Department of Research and Development, Association AGIR à dom, HP2 Laboratory, INSERM U 1042, Meylan, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Arnol
authors.affiliation: Department of Research and Development, Association AGIR à dom, HP2 Laboratory, INSERM U 1042, Meylan, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Zerillo
authors.affiliation: Thorax and Vessels Division, Sleep Laboratory, Grenoble Alpes University, HP2 Laboratory, INSERM U 1042, Grenoble, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: Tamisier
authors.affiliation: Thorax and Vessels Division, Sleep Laboratory, Grenoble Alpes University, HP2 Laboratory, INSERM U 1042, Grenoble, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Pepin
authors.affiliation: Department of Research and Development, Association AGIR à dom, HP2 Laboratory, INSERM U 1042, Meylan, France; Thorax and Vessels Division, Sleep Laboratory, Grenoble Alpes University, HP2 Laboratory, INSERM U 1042, Grenoble, France.
authors.forename: Jean-Christian
authors.initials: JC
authors.lastname: Borel
mesh_terms: D000367:Age Factors; D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation / Q000379:methods*; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D000068998:Humidifiers; D008297:Male; D008397:Masks; D015508:Nasal Obstruction / Q000453:epidemiology*; D056128:Obesity, Abdominal / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000628:therapy*
keywords: CPAP; compliance; mask; sleep apnea; unintentional leakage