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Nasal Cannula Treatment for Sleep Apnea Patients

Researchers at Johns Hopkins University have found that symptoms in patients with obstructive sleep apnea and hypopnea can be significantly reduced through treatment with nasal insufflation (TNI), using a nasal cannula to deliver warm, humidified air at a high flow rate.

Our findings provide evidence that TNI may offer a viable treatment alternative to patients with obstructive hypopneas and apneas, said lead researcher Hartmut Schneider, M.D., of Johns Hopkins Asthma and Allergy Center.

The research was reported in the second issue for July 2007 of the American Journal of Respiratory and Critical Care Medicine published by the American Thoracic Society.

The proof of concept study included 11 patients with mild to severe apnea-hypopnea disorders, who were selected to provide a balanced range of disease severity. Apnea was defined as complete cessation of airflow for more than 10 seconds. Hypopnea was defined as a greater than 30 percent reduction of airflow.

After baseline data were established for each patient while undergoing TNI at 0, 10 and 20L/minute, subjects were randomized to receive either no treatment or treatment with TNI at 20L/minute on separate nights. Researchers then measured airflow and superglottic pressure and monitored body position, sleep arousals and respiratory events.

At TNI of 10L/minute, some indications of disordered breathing showed improvement, but airflow limitations and snoring persisted. However, at TNI of 20L/minute, all patients showed a marked improvement. When TNI was administered, sleep and breathing patterns stabilized, said Dr. Schneider.

Furthermore, the results showed that even patients with more severe disorders gained significantly from TNI. Although we expected marked improvements in the apnea-plus-hypopnea index (AHI) primarily in patients with hypopneas rather than obstructive apneas, TNI lowered the AHI in all subjects, the researchers wrote.
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