Adel Bachour1, Kirsti Hurmerinta, Paula Maasilta. 1. Department of Pulmonary Medicine, Helsinki University Central Hospital, P.O. Box 340, Hus FIN 00029, Finland. adel.bachour@hus.fi
Abstract
BACKGROUND AND PURPOSE: Mouth leak occasionally complicates continuous positive airway pressure (CPAP) therapy, which leads to discomfort. While a chinstrap prevents the mouth from opening during sleep, its efficacy in diminishing mouth leak has not been studied. PATIENTS AND METHODS: Fifteen patients with mouth leak complaining of mouth dryness and nasal obstruction underwent two consecutive overnight polysomnographies, one with a chinstrap, in random order. Cephalometry with and without a chinstrap was randomly performed on six patients. RESULTS: With the chinstrap, both mouth leak and the arousal index decreased significantly, from (mean+/-SD) 42.9+/-23.5 to 23.8+/-13.3% of total sleep time (TST), and from 33.4+/-18.6 to 23.6+/-9.3/sleep hour, respectively. However, snoring time showed a concomitant increase from 6.7+/-14.3 to 24.0+/-13.2% of TST. The arousal index was significantly higher during leak periods, and its changes correlated positively with changes in mouth leak. Cephalometric measures showed a significant decrease in anterior lower facial height. CONCLUSIONS: The chinstrap, by closing the mouth during CPAP, reduces mouth leak and therefore the arousal index in most patients. Nevertheless, the indices remained unacceptably high. The chinstrap may also increase snoring and, in rare cases, can worsen the respiratory disturbance index. Consideration of these potential effects is important before instituting regular home use of the chinstrap.
RCT Entities:
BACKGROUND AND PURPOSE:Mouth leak occasionally complicates continuous positive airway pressure (CPAP) therapy, which leads to discomfort. While a chinstrap prevents the mouth from opening during sleep, its efficacy in diminishing mouth leak has not been studied. PATIENTS AND METHODS: Fifteen patients with mouth leak complaining of mouth dryness and nasal obstruction underwent two consecutive overnight polysomnographies, one with a chinstrap, in random order. Cephalometry with and without a chinstrap was randomly performed on six patients. RESULTS: With the chinstrap, both mouth leak and the arousal index decreased significantly, from (mean+/-SD) 42.9+/-23.5 to 23.8+/-13.3% of total sleep time (TST), and from 33.4+/-18.6 to 23.6+/-9.3/sleep hour, respectively. However, snoring time showed a concomitant increase from 6.7+/-14.3 to 24.0+/-13.2% of TST. The arousal index was significantly higher during leak periods, and its changes correlated positively with changes in mouth leak. Cephalometric measures showed a significant decrease in anterior lower facial height. CONCLUSIONS: The chinstrap, by closing the mouth during CPAP, reduces mouth leak and therefore the arousal index in most patients. Nevertheless, the indices remained unacceptably high. The chinstrap may also increase snoring and, in rare cases, can worsen the respiratory disturbance index. Consideration of these potential effects is important before instituting regular home use of the chinstrap.
Authors: Shelley R Knowles; Daniel T O'Brien; Shiling Zhang; Anupama Devara; James A Rowley Journal: J Clin Sleep Med Date: 2014-04-15 Impact factor: 4.062
Authors: Hendrik S Fischer; Charles C Roehr; Hans Proquitté; Hannes Hammer; Roland R Wauer; Gerd Schmalisch Journal: Intensive Care Med Date: 2009-11 Impact factor: 17.440
Authors: Hendrik Stefan Fischer; Charles Christoph Roehr; Hans Proquitté; Gerd Schmalisch Journal: World J Pediatr Date: 2013-10-21 Impact factor: 2.764
Authors: Sharn Rowland; Vinod Aiyappan; Cathy Hennessy; Peter Catcheside; Ching Li Chai-Coezter; R Doug McEvoy; Nick A Antic Journal: J Clin Sleep Med Date: 2018-01-15 Impact factor: 4.062