Performance of the NOSE Questionnaire in Mask Selection for Home CPAP Titration

Area of Science:

• Sleep Medicine
• Respiratory Medicine
• Medical Device Technology

Background:

• Continuous Positive Airway Pressure (CPAP) therapy is a primary treatment for obstructive sleep apnea (OSA).
• Patient adherence to CPAP is often limited by mask discomfort, leading to treatment abandonment.
• Airway assessment tools may help predict treatment success and improve mask selection.

Purpose of the Study:

• To evaluate the Nasal Obstruction Symptom Evaluation (NOSE) scale's ability to predict nasal ventilation failure in OSA patients undergoing home CPAP titration.
• To determine if NOSE scores correlate with the type of CPAP mask selected.
• To assess the relationship between NOSE scores and CPAP titration performance indicators.

Main Methods:

• Prospective correlational study involving 303 patients with OSA undergoing home-based auto-adjusting CPAP titration.
• Nasal Obstruction Symptom Evaluation (NOSE) scale administered to assess nasal obstruction symptoms.
• Patients categorized based on NOSE scores (e.g., >50 vs. <50).
• Correlation analysis between NOSE scores and mask selection, compliance, therapeutic pressure, residual Apnea-Hypopnea Index (AHI), and mask leak.

Main Results:

• The mean NOSE score was 24.3 ± 22.8; 13.8% of patients had scores >50.
• No significant differences were found in compliance, therapeutic pressure, residual AHI, or mask leak between groups with NOSE scores >50 and <50.
• Adjusted multiple regression analysis indicated that a NOSE score >50 was not a predictor of mask selection.

Conclusions:

• A NOSE score greater than 50 was not found to be a predictor for CPAP mask selection in this patient cohort.
• The NOSE scale did not demonstrate a correlation with key CPAP titration performance metrics, including compliance and efficacy.
• Further research may be needed to identify reliable predictors for optimizing CPAP mask selection and improving patient adherence.