Positive Airway Pressure-Related Aerophagia in Obstructive Sleep Apnea: Results from the InterfaceVent Real-Life...

Background: Continuous positive airway pressure (CPAP) effectiveness can be compromised by adverse effects. Despite its potential impact on adherence and sleepiness, aerophagia remains under-recognized and poorly characterized. This ancillary analysis of the InterfaceVent study aimed to identify risk factors for aerophagia in a large real-life cohort of CPAP-treated patients and to assess its association with both CPAP adherence and sleepiness. Methods: InterfaceVent was a prospective, real-life, cross-sectional study. Adults treated for at least 3 months with CPAP were included. Patients self-reported mask-related side effects using visual analogue scales. Aerophagia was defined as a dichotomous outcome based on patient-reported symptoms and CPAP non-adherence as mean nightly usage <4 h. Sleepiness was assessed using Epworth Sleepiness Scale (ESS). Results: A total of 1461 patients (median age 67 years (Q1-Q3; 60-74); 27.6% women) were included. Aerophagia was reported by 8.3% of participants. Compared to patients without aerophagia, those affected were younger, more frequently female, and had lower BMI. Patients with aerophagia reported a median ESS score of 7 (4-10) versus 5 (3-8) for patients without aerophagia (p < 0.001). CPAP usage was significantly lower in the aerophagia group (median 6.37 vs. 6.75 h/day; p = 0.001), whereas non-adherence, did not significantly differ between groups (10.7% vs. 7.5%; p = 0.20). Conclusions: This ancillary analysis of the InterfaceVent study highlights the burden of aerophagia in CPAP-treated patients and identifies modifiable and non-modifiable risk factors. Better recognition and management of this under-reported side effect may improve CPAP adherence and patient comfort. Trial registration: InterfaceVent is registered with ClinicalTrials.gov (NCT03013283). The first registration date is 23 December 2016.