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Upper airway discomfort and side effects like nasal congestion, dry nose or throat are among the most common adverse effects of nCPAP therapy. Various types of humidifiers have been used to ameliorate these adverse effects. The aim of this article is to review the available evidence on beneficial effects of humidifiers on therapeutic effectivity of CPAP therapy, comfort and compliance in patients on nCPAP therapy for obstructive sleep apnoea (OSA). The available data provide solid evidence for beneficial effects of heated humidifiers in symptomatic patients with upper airway dryness during nasal CPAP therapy for OSA. The clinical benefit from cold passover humidifiers is significantly lower and their effect is clinically often insufficient. The clinical benefits of heated humidifiers in symptomatic patients are superior to the effects of humidifiers used "prophylactical" in patients who had not been symptomatic before. With the use of heated humidifiers, CPAP compliance can be significantly improved and the number of CPAP patients discontinuing their therapy can be significantly reduced. [ABSTRACT FROM AUTHOR]

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Due to the importance of arousals for the interpretation of sleep wake disturbances, origin and meaning, methodological aspects and clinical relevance are discussed. There exist multiple entero- and exteroceptive arousal stimuli followed by EEG, autonomic and behavioral arousals. Also in pediatric sleep medicine the analysis of arousals is of great importance, because disturbances of the arousal mechanism can play a causal role for life threatening events or daytime somnolence. Despite clear criteria for the diagnosis of arousals (ASDA) there exists a certain interrater variability leading to different evaluation of sleep fragmentation. Automatic computer analysis offers no alternative: the results should always be controlled and eventually corrected by trained experts. In the last years the detection rate of respiratory events with consecutive EEG arousals was improved by non invasive methods as measurement of pressure with nasal prongs, impedance or effort/phase angle. The registration of pulse- transit-time and continously measured blood pressure allows to quantify autonomic arousals. By examples of different diseases as obstructive sleep apnea, central sleep apnea, chronic obstructive lung disease, periodic movement during sleep, psychophysiological insomnias, epilepsy, parasomnias and hypersonmias the effects of arousals are discussed. Additionally to arousals further... [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnoea (OSA) is a common condition that is associated with several important comorbidities and increased mortality. Positive airway pressure (PAP) is an effective treatment for OSA that is associated with a reduction in mortality. This study investigated the prevalence and predictors of PAP prescription for OSA in Germany.This retrospective observational study used an anonymized German claims research database. Adults (age ≥ 18 years) with treatment-naïve OSA who were or were not started on PAP were included.Of 22,317 participants, 12,297 (55%) were started on PAP; the remaining 10,020 individuals (45%) formed the control group (no PAP). Significant predictors of PAP prescription in multivariate logistic regression analysis were overweight/obesity, hypertension, heart failure, other cardiovascular diseases, gastro-oesophageal reflux disease, breathing abnormalities, vasomotor and allergic rhinitis, somatoform disorders and use of several medication classes (especially angiotensin receptor blockers, inhaled adrenergics or other inhaled drugs).Only just over half of all individuals with OSA in the current analysis were prescribed PAP. The presence of a variety of comorbidities and use of several medication classes were significant predictors of PAP prescription. Future research should focus on identifying ways to increase PAP use in eligible individuals to optimize clinical outcomes.Methods: Obstructive sleep apnoea (OSA) is a common condition that is associated with several important comorbidities and increased mortality. Positive airway pressure (PAP) is an effective treatment for OSA that is associated with a reduction in mortality. This study investigated the prevalence and predictors of PAP prescription for OSA in Germany.This retrospective observational study used an anonymized German claims research database. Adults (age ≥ 18 years) with treatment-naïve OSA who were or were not started on PAP were included.Of 22,317 participants, 12,297 (55%) were started on PAP; the remaining 10,020 individuals (45%) formed the control group (no PAP). Significant predictors of PAP prescription in multivariate logistic regression analysis were overweight/obesity, hypertension, heart failure, other cardiovascular diseases, gastro-oesophageal reflux disease, breathing abnormalities, vasomotor and allergic rhinitis, somatoform disorders and use of several medication classes (especially angiotensin receptor blockers, inhaled adrenergics or other inhaled drugs).Only just over half of all individuals with OSA in the current analysis were prescribed PAP. The presence of a variety of comorbidities and use of several medication classes were significant predictors of PAP prescription. Future research should focus on identifying ways to increase PAP use in eligible individuals to optimize clinical outcomes.Results: Obstructive sleep apnoea (OSA) is a common condition that is associated with several important comorbidities and increased mortality. Positive airway pressure (PAP) is an effective treatment for OSA that is associated with a reduction in mortality. This study investigated the prevalence and predictors of PAP prescription for OSA in Germany.This retrospective observational study used an anonymized German claims research database. Adults (age ≥ 18 years) with treatment-naïve OSA who were or were not started on PAP were included.Of 22,317 participants, 12,297 (55%) were started on PAP; the remaining 10,020 individuals (45%) formed the control group (no PAP). Significant predictors of PAP prescription in multivariate logistic regression analysis were overweight/obesity, hypertension, heart failure, other cardiovascular diseases, gastro-oesophageal reflux disease, breathing abnormalities, vasomotor and allergic rhinitis, somatoform disorders and use of several medication classes (especially angiotensin receptor blockers, inhaled adrenergics or other inhaled drugs).Only just over half of all individuals with OSA in the current analysis were prescribed PAP. The presence of a variety of comorbidities and use of several medication classes were significant predictors of PAP prescription. Future research should focus on identifying ways to increase PAP use in eligible individuals to optimize clinical outcomes.Conclusion: Obstructive sleep apnoea (OSA) is a common condition that is associated with several important comorbidities and increased mortality. Positive airway pressure (PAP) is an effective treatment for OSA that is associated with a reduction in mortality. This study investigated the prevalence and predictors of PAP prescription for OSA in Germany.This retrospective observational study used an anonymized German claims research database. Adults (age ≥ 18 years) with treatment-naïve OSA who were or were not started on PAP were included.Of 22,317 participants, 12,297 (55%) were started on PAP; the remaining 10,020 individuals (45%) formed the control group (no PAP). Significant predictors of PAP prescription in multivariate logistic regression analysis were overweight/obesity, hypertension, heart failure, other cardiovascular diseases, gastro-oesophageal reflux disease, breathing abnormalities, vasomotor and allergic rhinitis, somatoform disorders and use of several medication classes (especially angiotensin receptor blockers, inhaled adrenergics or other inhaled drugs).Only just over half of all individuals with OSA in the current analysis were prescribed PAP. The presence of a variety of comorbidities and use of several medication classes were significant predictors of PAP prescription. Future research should focus on identifying ways to increase PAP use in eligible individuals to optimize clinical outcomes. [ABSTRACT FROM AUTHOR]