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High-flow nasal cannula compared with continuous positive airway pressure in the treatment of obstructive sleep apnea

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Continuous positive airway pressure (CPAP) is a standard treatment for obstructive sleep apnea (OSA). However, CPAP has limitations. High-flow nasal cannula (HFNC) is already in use for various types of respiratory diseases. As HFNC generates positive airway pressure, it may be a potential candidate for OSA treatment. This prospective study compared the therapeutic effects of HFNC to CPAP in patients with OSA.

Methods

Patients whose apnea–hypopnea index (AHI) was > 5 events/h were enrolled in this study. All participants were randomly divided into two groups. The first group underwent CPAP the first night and HFNC the second night. Conversely, the second group received HFNC the first night and CPAP the second night. Their respiratory events and sleep quality were compared using baseline polysomnography, CPAP, and HFNC.

Results

In total, 28 participants completed this study. Median [interquartile range] AHI (35.0 [20.0–48.6] vs. 10.8 [5.5–20.6] events/h; p < 0.001) was significantly improved by the HFNC. However, sleep quality was not improved. When CPAP was compared directly with HFNC, CPAP demonstrated a more favorable effect for respiratory events (AHI 5.0 [2.0–7.0] vs. 10.8 [5.5–20.6] events/h; p < 0.001) and sleep efficiency (88.1 [79.9–92.5] vs. 77.9 [69.2–86.6] %; p = 0.001).

Conclusion

The efficacy of CPAP was superior to HFNC for both respiratory events and sleep quality.

Trial registration

ClinicalTrials.gov Identifier: NCT03843372; URL: www.clinicaltrials.gov; Date of registration: November 2, 2019

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Acknowledgements

The authors would like to thank Chang Gung Memorial Hospital Medical Research Council for financial support and the Sleep Center of Keelung, Keelung, Taiwan for data collection and technical assistance.

Funding

This work was supported by the Chang Gung Medical Research Council of Keelung, Taiwan, ROC (grant number CMRPG2H0021).

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Authors and Affiliations

  1. Division of Pulmonary, Critical Care, and Sleep Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan

    Chung-Chieh Yu, Chih-Yu Huang, Chung-Ching Hua & Huang-Pin Wu

  2. Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Chung-Chieh Yu, Chih-Yu Huang, Chung-Ching Hua & Huang-Pin Wu

  3. Department of Respiratory Therapy, Chang Gung Memorial Hospital, Keelung, Taiwan

    Chung-Chieh Yu, Chih-Yu Huang, Chung-Ching Hua & Huang-Pin Wu

Authors
  1. Chung-Chieh Yu
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  2. Chih-Yu Huang
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Contributions

C.C.Y. designed the study, conducted subject enrollment, data analysis, and drafted the manuscript. C.Y.H. participated in patient screening, enrollment, and data collection. C.C.H. provided statistical analysis and expert opinions. H.P.W. assisted study design, data analysis, reviewed manuscript, and revised important content.

Corresponding author

Correspondence to Huang-Pin Wu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Not applicable.

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The authors declare no competing interests.

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Yu, CC., Huang, CY., Hua, CC. et al. High-flow nasal cannula compared with continuous positive airway pressure in the treatment of obstructive sleep apnea . Sleep Breath 26, 549–558 (2022). https://doi.org/10.1007/s11325-021-02413-0

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  • DOI: https://doi.org/10.1007/s11325-021-02413-0

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