NEW YORK (Reuters Health) - Using a single nasal tube to deliver warm, humidified air at a high flow rate may improve treatment outcomes for patients with sleep apnea syndrome, according to the results of a pilot study conducted at Johns Hopkins University in Baltimore. Because it is minimally intrusive, patients may use the device more consistently than they use continuous positive airway pressure, which is delivered by a nasal mask.
Sleep apnea occurs when breathing passages become obstructed during sleep, often when soft tissues around the larynx and throat collapse inward. Breathing can be interrupted temporarily but frequently, often accompanied by snoring.
The condition, which is often seen in people who are obese, can lead to daytime drowsiness caused by frequent interruptions in sleep triggered when oxygen is cut off. Other complications include high blood pressure, stroke and heart disease.
Sleep apnea can be prevented by raising nasal pressure, Dr. Hartmut Schneider and colleagues explain in the American Journal of Respiratory and Critical Care Medicine. While CPAP is the widely accepted treatment, low adherence impedes its therapeutic effectiveness.
Schneider's group examined the effectiveness of treatment with oxygen supplied by a nasal tube in 11 patients with sleep apnea, ranging from mild to severe. A heater and humidifier regulated the temperature and humidity of the air, which was delivered by a compressor to the nasal tube.
With an air flow rate of 20 liters per minute, sleep and breathing patterns stabilized in all of the subjects and the average number of apnea events was reduced.
The results "demonstrate clinical proof of concept" that oxygen therapy using a single nasal tube is a viable alternative to CPAP, Schneider and his associates conclude. Furthermore, they propose that using a fixed flow rate and tube size can provide a "streamlined therapeutic approach...for a large proportion of patients with sleep apnea."
SOURCE: American Journal of Respiratory and Critical Care Medicine, July 15, 2007.
