Obstructive sleep apnea affects around 20 million Americans and can lead to hypertension, heart attack, stroke, depression, muscle pain, fibromyalgia, morning headaches, and excessive daytime sleepiness.

Sunday, July 4, 2010

Nasal Symptoms from CPAP Decreased with Heated Humidification. Patients Prefer Oral Appliances.

This blog entry is a reprint of a recent press release:

Nasal CPAP frequently causes problematic nasal symptoms including congestion, dry nasal tissues, nasal itchin, and sinus pain. A recent study showed that heated humidification decreases nasal inflamation.


PRLog (Press Release) – Jul 03, 2010 – A recent study "Nasal inflammation in sleep apnoea patients using CPAP and effect of heated humidification." (see PubMed abstract below) looked at nasal symptoms caused by nasal CPAP. CPAP is considred the gold stanard of treatment but is rejected by 60% of patients accoring to recent studies. Many patients abandon CPAP in favor of Comfortable Oral Appliances http://www.ihatecpap.com The current study concluded that heated humidification "nasal obstruction of OSA patients on CPAP treatment is inflammatory in origin, and the addition of heated humidification decreases nasal resistance and mucosal inflammation. "

The percentage of patients who tolerate CPAP is usually determined by the initial experience with CPAP. CPAP suppliers should consider starting CPAP on all patients with the use heated humidification to improve compliance.

Many studies have shown that oral appliances have much higher compliance and patient satisfaction ratings than CPAP. There is a growing sentiment that for mild to moderate sleep apnea and snoring Dental Sleep Medicine and Oral Appliances should precede CPAP trial.

Oral Appliance compliance and patient satisfaction far exceeds those ratings for CPAP. Examples of many oral appliances can be found at: http://www.ihatecpap.com/oral_appliance.html

Patients in Chicago, Northern Illinois an Southern Wisconsin should contact Dr Ira L Shapira at Chicagoland Dental Sleep Medicine Associates for information and treatment of sleep apnea and snoring with a comfortable appliance.

Dr Shapira can be reached at 1-8-NO-PAP-MASK or thru his websites:

Eur Respir J. 2010 Jul 1. [Epub ahead of print]
Nasal inflammation in sleep apnoea patients using CPAP and effect of heated humidification.
Koutsourelakis I, Vagiakis E, Perraki E, Karatza M, Magkou C, Kopaka M, Roussos C, Zakynthinos S.

Medical School of Athens University, Dept of Critical Care and Pulmonary Services, Evangelismos Hospital.
Nasal continuous positive airway pressure (CPAP) can cause undesirable nasal symptoms such as congestion to obstructive sleep apnoea (OSA) patients, which symptoms can be attenuated by the addition of heated humidification. However, neither the nature of nasal symptoms nor the effect of heated humidification on nasal pathophysiology and pathology are convincingly known. Twenty patients with OSA on nasal CPAP who exhibited symptomatic nasal obstruction were randomized to receive either 3 weeks of CPAP treatment with heated humidification or 3 weeks of CPAP treatment with sham-heated humidification, followed by 3 weeks of the opposite treatment, respectively. Nasal symptom score, nasal resistance, nasal lavage interleukin-6, interleukin-12 and tumour necrosis factor-a, and nasal mucosa histopathology were assessed at baseline and after each treatment arm. Heated humidification in comparison with sham-heated humidification was associated with decrease in nasal symptomatology, resistance and lavage cytokines, and attenuation of inflammatory cell infiltration and fibrosis of the nasal mucosa. In conclusion, "nasal obstruction of OSA patients on CPAP treatment is inflammatory in origin, and the addition of heated humidification decreases nasal resistance and mucosal inflammation. Trial Registration clinicaltrials.gov Identifier: NCT00850876.

PMID: 20595158 [PubMed - as supplied by publisher]

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Dr Shapira is the founder of I HATE CPAP LLC that promotes awareness of the dagers of sleep apnea and promotes the field of Dental Sleep Medicine.

He is a Diplomate of the American Board of Dental Sleep Medicine and founder of Chicagoland Dental Sleep Medicine Associates. He is a former Assistant Professor at Rush Medical School's Sleep center and has been involved in research and treatment of sleep apnea with oral appliances since the early 1980's.

Dr Shapira also founded I HATE Headaches LLC and the website www.ihateheadaches.org. He has several device and/or method patents on collection of stem cells from the jaws and developing wisdom tooth buds.

Dr Shapira is the Dental Section Editor of Sleep and Health Journal and has chaptered a chapter in a bmedical textbook on Anti-Aging Medicine.

Delany Dental Care was founded in 1984 as a general dental practice with special emphasis on treating sleep apnea, snoring, headaches, migraines and Temporomandibular (TMJ) disorders

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posted by Dr Shapira at 7:14 PM