Dataset Information

The Efficacy of Low-Level Continuous Positive Airway Pressure for the Treatment of Snoring.

ABSTRACT:

Study objectives

To assess effects of low-level continuous positive airway pressure (CPAP) on snoring in habitual snorers without obstructive sleep apnea (OSA).

Methods

A multicenter prospective in-laboratory reversal crossover intervention trial was conducted between September 2013 and August 2014. Habitual snorers were included if they snored (inspiratory sound pressure level ≥ 40 dBA) for ≥ 30% all sleep breaths on a baseline sleep study (Night 1), and if significant OSA and daytime somnolence were absent. Included participants then underwent a CPAP titration study at 2, 4, or 6 cm H₂O (Night 2) to examine snoring responses to step-increases in nasal pressure, a treatment night at optimal pressure (Night 3), followed by baseline night (Night 4). At each pressure, snoring intensity was measured on each breath. Snoring frequency was quantified as a percentage of sleep breaths at thresholds of 40, 45, 50, and 55 dBA. Sleep architecture and OSA severity were characterized using standard measurements.

Results

On baseline sleep studies, participants demonstrated snoring at ≥ 40 dBA on 53 ± 3% and ≥ 45 dBA on 35 ± 4% of breaths. Snoring frequency decreased progressively as nasal pressure increased from 0 to 4 cm H₂O at each threshold, and plateaued thereafter. CPAP decreased snoring frequency by 67% and 85% at 40 and 45 dBA, respectively. Intervention did not alter sleep architecture and sleep apnea decreased minimally.

Conclusions

Low-level CPAP below the range required to treat OSA diminished nocturnal snoring, and produced uniform reduction in nightly noise production below the World Health Organization's limit of 45 dBA.

Clinical trial registration

ClinicalTrials.gov, identifier: NCT01949584.

SUBMITTER: Guzman MA

PROVIDER: S-EPMC5406953 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The Efficacy of Low-Level Continuous Positive Airway Pressure for the Treatment of Snoring.

Guzman Michelle A MA Sgambati Francis P FP Pho Huy H Arias Rafael S RS Hawks Erin M EM Wolfe Erica M EM Ötvös Tamás T Rosenberg Russell R Dakheel Riad R Schneider Hartmut H Kirkness Jason P JP Smith Philip L PL Schwartz Alan R AR

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 20170515 5

<h4>Study objectives</h4>To assess effects of low-level continuous positive airway pressure (CPAP) on snoring in habitual snorers without obstructive sleep apnea (OSA).<h4>Methods</h4>A multicenter prospective in-laboratory reversal crossover intervention trial was conducted between September 2013 and August 2014. Habitual snorers were included if they snored (inspiratory sound pressure level ≥ 40 dBA) for ≥ 30% all sleep breaths on a baseline sleep study (Night 1), and if significant OSA and da ...[more]

PMID: 28356182

Similar Datasets

Project description:BackgroundLarge tidal volumes during de novo acute hypoxemic respiratory failure (AHRF) may promote patient self-inflicted lung injury. Tidal volume assessment under high flow nasal cannula (HFNC) is not routinely feasible at the bedside. Our objective was to determine whether tidal volume during low-level continuous positive airway pressure (CPAP) could predict tidal volume during HFNC and to compare the physiological effects of HFNC and low-level CPAP.MethodsProspective, single-center study including 29 de novo AHRF patients treated with HFNC (50 to 60 L.min- 1). Patients were monitored using electrical impedance tomography during HFNC then CPAP at 4 cmH2O. Tidal volume during HFNC was calculated based on tidal impedance variation. The ability of tidal volume under low-level CPAP to predict tidal volume under HFNC was explored using Bland-Altman analysis. CPAP and HFNC were compared in terms of tidal volume, minute ventilation, respiratory comfort, dyspnea, oxygenation, ventilation distribution, end-expiratory lung volume, thoraco-abdominal asynchrony and recruitment.ResultsUnder HFNC, patients had a tidal volume of 6.6 (5.9-8.7) mL.kg- 1 PBW. 20 (69%) patients exhibited a tidal volume between 4 and 8 mL.kg- 1 PBW, while in 5 (17%) patients it exceeded 9 mL.kg- 1 PBW. Tidal volume under CPAP was higher (9.4 (8.3-11) mL.kg- 1 PBW, p < 0.001). Tidal volumes under CPAP and under HFNC were modestly correlated (Spearman r = 0.50, p = 0.005). Bland-Altman analysis showed a bias of 2.4 mL.kg- 1, with limits of agreement ranging from - 1.1 mL.kg- 1to 5.9 mL.kg- 1. Nevertheless, a larger (> 11.5 mL.kg- 1 PBW ) tidal volume under low-level CPAP predicted a larger (> 9 mL.kg- 1 PBW ) tidal volume under HFNC with 80% sensitivity and 96% specificity. Low-level CPAP was associated with increased minute ventilation, end-expiratory lung volume, and oxygenation as compared to HFNC. It decreased signs of respiratory distress in the most severe patients but was associated with lower comfort compared to HFNC.ConclusionAmong ICU patients with de novo AHRF, tidal volume under HFNC was mostly protective. Tidal volume during CPAP at 4 cmH2O did not predict tidal volume during HFNC. Such low-level CPAP was associated with increased tidal volume, minute ventilation, end-expiratory volume, and oxygenation.Trial registrationClinicalTrials.gov ID NCT03919331. Registration date: 2019-03-26.

Dataset Information

The Efficacy of Low-Level Continuous Positive Airway Pressure for the Treatment of Snoring.

Study objectives

Methods

Results

Conclusions

Clinical trial registration

Publications

The Efficacy of Low-Level Continuous Positive Airway Pressure for the Treatment of Snoring.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets