Adherence to Continuous Positive Airway Pressure Therapy

The Proceedings of the American Thoracic Society , 2008

Authors: Terri E. Weaver and Ronald R. Grunstein

Relevance: “There is emerging evidence that increased nasal resistance affects CPAP use and initial acceptance of this treatment. Using acoustic rhinometry to measure the internal dimensions of the airway, those patients with smaller nasal cross-sectional area and reduced volume were much less likely to be adherent. Age-adjusted minimum cross-sectional area explained 22% of the variance in CPAP adherence. Interestingly, self-reported nasal stuffiness was not associated with nasal dimensions. Nasal resistance/obstruction also seems to influence the initial acceptance of CPAP treatment, with increased nasal pressure resulting in a 50% greater chance of rejecting CPAP as a treatment. Acceptance of CPAP was improved with nasal surgery, suggesting that the nasal cavity should be thoroughly evaluated before treatment, and surgery initiated for patients presenting with either total nasal resistance of more than 0.38 mm Hg/cm3 per second, nasal obstruction that would not be decreased with medical treatment, nasal septum deviation, or inferior turbinate hypertrophy.”