Frequency of upper airway symptoms before and during continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome.

BACKGROUND Upper airway side effects are common during nasal continuous positive airway pressure (nCPAP) treatment and may affect the use of nCPAP. OBJECTIVES It was our aim to evaluate the prevalence of upper airway symptoms in obstructive sleep apnea syndrome (OSAS) patients before and during nCPAP treatment and to assess the possible association between the symptoms and long-term adherence to the treatment. METHODS We examined 385 consecutive OSAS patients (79% men, mean age ± SD 52 ± 10 years and apnea-hypopnea index 33 ± 23) by means of a prospective questionnaire-based survey. The patients filled in questionnaires about upper airway symptoms before starting nCPAP and after 2 months of treatment. RESULTS Upper airway symptoms were common before starting nCPAP: 61% of the patients reported dryness of mouth, 54% dryness of throat, 52% nasal stuffiness, 51% dryness of nose, 30% sneezing, 24% mucus in throat, 17% rhinorrhea, and 6% nose bleeds daily or almost daily. In CPAP users there was a significant decline in the number of patients with frequent mouth (37%), throat (34%), nose (28%) dryness and nasal stuffiness (24%). There was no difference in upper airway symptoms before nCPAP treatment between those who continued the treatment after 1 year and those who terminated the treatment. CONCLUSIONS The most common upper airway symptoms in patients with untreated OSAS seem to be associated with mucosal dryness. These symptoms improved during nCPAP treatment probably due to the change in breathing pattern. The occurrence of upper airway symptoms before nCPAP start did not predict long-term adherence to the treatment.