Gel pillow designed specifically for obstructive sleep apnea treatment with continuous positive airway pressure.

OBJECTIVE:: To determine whether the use of a gel pillow with side cutouts designed to accommodate a continuous positive airway pressure (CPAP) mask and reduce head temperature improves the efficacy of and adherence to auto-CPAP therapy. METHODS:: Twenty-three consecutive CPAP-naïve patients with obstructive sleep apnea were enrolled in the study. Patients were given an auto-CPAP machine with an appropriate CPAP mask and were instructed to use CPAP for 15 nights. They were instructed to sleep with their own pillow (the control pillow) from nights 1 to 5 and with either a foam pillow or a gel pillow, both of which had side cutouts, for 5 consecutive nights each, in random order. After night 15, auto-CPAP machine data were downloaded and patients rated their satisfaction with each pillow on a visual analog scale. RESULTS:: Twenty-two patients completed the protocol. The pressures administered, residual apnea-hypopnea index, air leaks, and mean duration of CPAP use did not differ among the periods during which each pillow was used. Patients were significantly more satisfied with the gel pillow than with the control pillow and the foam pillow (p = 0.022 and p = 0.004, respectively), their level of satisfaction with the gel pillow correlating significantly with excessive daytime sleepiness (r2 = 0.19; p = 0.0443). CONCLUSIONS:: Among obstructive sleep apnea patients treated with nasal CPAP, the use of a gel pillow with side cutouts appears to have no impact on treatment effectiveness. Nevertheless, such patients seem to prefer a gel pillow over other types of pillows. OBJETIVO:: Determinar se o uso de um travesseiro de gel com recortes laterais para acomodar a máscara de continuous positive airway pressure (CPAP, pressão positiva contínua nas vias aéreas) e diminuir a temperatura em torno da cabeça melhora a eficácia do tratamento com auto-CPAP e a adesão dos pacientes ao tratamento. MÉTODOS:: Foram incluídos no estudo 23 pacientes consecutivos com apneia obstrutiva do sono que nunca haviam recebido tratamento com CPAP. Os pacientes receberam um aparelho de auto-CPAP com uma máscara apropriada e foram instruídos a usar CPAP durante 15 noites. Foram também instruídos a dormir com seu próprio travesseiro (o travesseiro controle) nas 5 primeiras noites e com um travesseiro de espuma ou um travesseiro de gel, ambos com recortes laterais, durante 5 noites consecutivas cada, em ordem aleatória. Depois da 15ª noite, os dados registrados nos aparelhos de auto-CPAP foram baixados e os pacientes determinaram seu grau de satisfação com cada travesseiro por meio de uma escala visual analógica. RESULTADOS:: Vinte e dois pacientes completaram o protocolo. Não houve diferenças entre os períodos durante os quais cada travesseiro foi usado quanto às pressões administradas, índice de apneia-hipopneia residual, vazamentos de ar e média de duração da CPAP. Os pacientes ficaram significativamente mais satisfeitos com o travesseiro de gel do que com o travesseiro controle e o travesseiro de espuma (p = 0,022 e p = 0,004, respectivamente), com correlação entre o grau de satisfação com o travesseiro de gel e a sonolência diurna excessiva (r2 = 0,19; p = 0,0443). CONCLUSÕES:: Em pacientes com apneia obstrutiva do sono tratados com CPAP nasal, o uso de um travesseiro de gel com recortes laterais aparentemente não tem nenhum impacto na eficácia do tratamento. No entanto, esses pacientes aparentemente preferem um travesseiro de gel a outros tipos de travesseiros.

Gel pillow designed specifically for obstructive sleep apnea treatment with continuous positive airway pressure / Travesseiro de gel com formato específico para o tratamento de apneia obstrutiva do sono com pressão positiva contínua nas vias aéreas

ABSTRACT Objective: To determine whether the use of a gel pillow with side cutouts designed to accommodate a continuous positive airway pressure (CPAP) mask and reduce head temperature improves the efficacy of and adherence to auto-CPAP therapy. Methods: Twenty-three consecutive CPAP-naïve patients with obstructive sleep apnea were enrolled in the study. Patients were given an auto-CPAP machine with an appropriate CPAP mask and were instructed to use CPAP for 15 nights. They were instructed to sleep with their own pillow (the control pillow) from nights 1 to 5 and with either a foam pillow or a gel pillow, both of which had side cutouts, for 5 consecutive nights each, in random order. After night 15, auto-CPAP machine data were downloaded and patients rated their satisfaction with each pillow on a visual analog scale. Results: Twenty-two patients completed the protocol. The pressures administered, residual apnea-hypopnea index, air leaks, and mean duration of CPAP use did not differ among the periods during which each pillow was used. Patients were significantly more satisfied with the gel pillow than with the control pillow and the foam pillow (p = 0.022 and p = 0.004, respectively), their level of satisfaction with the gel pillow correlating significantly with excessive daytime sleepiness (r2 = 0.19; p = 0.0443). Conclusions: Among obstructive sleep apnea patients treated with nasal CPAP, the use of a gel pillow with side cutouts appears to have no impact on treatment effectiveness. Nevertheless, such patients seem to prefer a gel pillow over other types of pillows.

RESUMO Objetivo: Determinar se o uso de um travesseiro de gel com recortes laterais para acomodar a máscara de continuous positive airway pressure (CPAP, pressão positiva contínua nas vias aéreas) e diminuir a temperatura em torno da cabeça melhora a eficácia do tratamento com auto-CPAP e a adesão dos pacientes ao tratamento. Métodos: Foram incluídos no estudo 23 pacientes consecutivos com apneia obstrutiva do sono que nunca haviam recebido tratamento com CPAP. Os pacientes receberam um aparelho de auto-CPAP com uma máscara apropriada e foram instruídos a usar CPAP durante 15 noites. Foram também instruídos a dormir com seu próprio travesseiro (o travesseiro controle) nas 5 primeiras noites e com um travesseiro de espuma ou um travesseiro de gel, ambos com recortes laterais, durante 5 noites consecutivas cada, em ordem aleatória. Depois da 15ª noite, os dados registrados nos aparelhos de auto-CPAP foram baixados e os pacientes determinaram seu grau de satisfação com cada travesseiro por meio de uma escala visual analógica. Resultados: Vinte e dois pacientes completaram o protocolo. Não houve diferenças entre os períodos durante os quais cada travesseiro foi usado quanto às pressões administradas, índice de apneia-hipopneia residual, vazamentos de ar e média de duração da CPAP. Os pacientes ficaram significativamente mais satisfeitos com o travesseiro de gel do que com o travesseiro controle e o travesseiro de espuma (p = 0,022 e p = 0,004, respectivamente), com correlação entre o grau de satisfação com o travesseiro de gel e a sonolência diurna excessiva (r2 = 0,19; p = 0,0443). Conclusões: Em pacientes com apneia obstrutiva do sono tratados com CPAP nasal, o uso de um travesseiro de gel com recortes laterais aparentemente não tem nenhum impacto na eficácia do tratamento. No entanto, esses pacientes aparentemente preferem um travesseiro de gel a outros tipos de travesseiros.

Effect of obstructive sleep apnea diagnosis on health related quality of life.

BACKGROUND: Perceived Health Related Quality of Life (HRQoL) is impaired in obstructive sleep apnea (OSA). To our knowledge, no study has analyzed the effect of OSA diagnosis communication on HRQoL. We evaluated self-perceived HRQoL in patients afferent to our sleep center, in order to examine the effect of the diagnosis disclosure on their HRQoL. METHODS: Two hundred ninety-seven consecutive outpatients (227 M) (mean age 54.1 ± 11.6 yrs, range 23-80 yrs) were evaluated, before first clinical visit and nocturnal diagnostic examination (Time A), and after diagnosis disclosure (Time B), with two self-reported questionnaires for HRQoL assessment: Psychological General Well-Being Index (PGWBI), consisting of anxiety, depressed mood, positive well-being, self-control, general health, vitality subscales, and 12-Item Short-Form Health Survey (SF-12), comprising Physical (PCS) and Mental Component Summaries (MCS). RESULTS: Comparison of mean HRQoL scores at Time A with reference values, showed worse scores. Mean PGWBI Total and subscales scores improved at Time B. Similar improvement was observed for SF-12 MCS (p = 0.0148), but nor for SF-12 PCS. At Time B, Anxiety, Depression and Well-being PGWBI subscales became similar to reference values, while the scores in the other PGWBI subscales and SF-12 remained worse. Comparison between males and females showed higher HRQoL values for males at both times. Score changes were independent from age, gender, BMI, AHI, TSat90 and excessive daytime sleepiness. CONCLUSIONS: Diagnosis communication improves patients' HRQoL, regardless of the severity. Changes in HRQoL after diagnosis disclosure may be due to patients' motivation for medical check and diagnostic expectations.

Usefulness of reinforcing interventions on continuous positive airway pressure compliance.

BACKGROUND: Obstructive sleep apnea (OSA) is a high prevalence sleep disorder characterized by upper airway obstruction during sleep, nocturnal intermittent hypoxemia, poor sleep quality, risk for cardiovascular and metabolic diseases. The adherence to CPAP is the key for an effective management of these patients.The aim of the study was to assess the adherence to CPAP therapy with and without early reinforcing interventions, consisting of motivational reinforcement and technical support in the first month of therapy. METHODS: Forty patients with OSA undergoing counseling and a one year follow-up on a quarterly basis were included in the study. Twenty subjects (intervention group) underwent reinforcing interventions with telephone interviews in the first month of therapy, and twenty (control group) remained without reinforcing interventions. The two populations were homogeneous for age, severity of illness and BMI. RESULTS: During the first month, intervention group patients showed a higher number of nights with a device use ≥4 hours. Average treatment adherence in the first month (days of therapy with at least 4 hours per night on the total number of days from device delivery) was 77.5% in the intervention group and 55.7% in the control group (p = 0.022). At one year the differences between the two groups were not significant. CONCLUSIONS: Our findings suggest that it is important that adequate time and effort is spent to ensure patient comfort at the time of CPAP therapy start to optimize acceptance and adherence to treatment, and suggest that it is necessary to maintain reinforcing interventions over time.