Otorhinolaryngological side effects of nocturnal nasal ventilation therapywith continuous positive airway pressure (nCPAP).

Background: Nasal continuous positive airway pressure ventilation therapy i s the present gold standard in the treatment of obstructive sleep apnea. De pending on the definitions used, about 60 % of the patients tolerate nCPAP therapy. The reason for this limited tolerance is a varying number of side effects. The aim of the present retrospective study was to analyze the inci dence and intensity of otorhinolaryngological side effects of nCPAP therapy . Method: Questionnaires inquiring about the frequency of using nCPAP and o bjective and subjective complaints were sent to 92 patients who were treate d with nCPAP in our departement within the last years, Six of 92 patients a lso used a heated humidifier. A telephone interview was added to complete t he questionnaires as correctly as possible. Results: Eighty questionnaires were sent back completely answered. The mean frequency of using nCPAP (+/- standard deviation) was 6.8 +/- 1.6 hours per night and 6.5 +/- 1.4 nights per week. The mean duration of nCPAP therapy was 28.0 +/- 21.0 months; the mean pressure used was 6.8 +/- 1.2 cm H2O. The following side effects were specified most frequently: disturbance of sleep during the night (71.3 %), dry mouth (47.5 %), dry nose (46.3 %), pressure marks by the mask (41.3 %), crusts within the nasal cavity (38.8 %), and hearing loss (26.3 %). Drynes s within the nose and mouth was considered the most irritating side effects . Conclusions: NCPAP therapy has a number of different side effects in the head and neck. These side effects are seen frequently. Prospective analysis must show whether there are correlations between the intensity and frequen cy of side effects and the duration of therapy, and whether technical impro vements (quality of masks, noise reduction, humidifiers) are able to reduce the frequency of side effects.