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Abstract Introduction Continuous positive airway pressure (CPAP) therapy is the most prescribed therapy for obstructive sleep apnea (OSA). CPAP therapy has been shown to reduce daytime somnolence as well as reduce the risk of cardiovascular disease and mortality in patients with severe OSA and good adherence. Nasal and oronasal masks are the two main mask interfaces available for CPAP therapy. The oronasal mask is a larger interface and prior research shows that with an oronasal mask higher PAP pressures are needed compared to a nasal mask. These factors may reduce long-term adherence to CPAP when an oronasal mask is initially selected. There are no guidelines for sleep technologists when selecting a mask type during CPAP titration studies, however using an oronasal mask could affect the long-term adherence to CPAP therapy. Methods We retrospectively studied mask selection amongst our sleep technologists from 6/15/2023 to 9/30/2023. Our institution employs 12 sleep technologists; 6 work at lab 1 and 6 work at lab 2. Results Overall, 368 patients (199 at lab 1 and 169 at lab 2) underwent CPAP titration studies during the study period. There were no significant differences in patient demographics between the two sleep labs, including mean age (57.3±14.8 vs 57.2±14.9, p=0.95), sex (48% female vs 48% female, p=0.97) and mean BMI (39.6±19.4 vs 38.6±10.7, p=0.38). The prevalence of oronasal mask use was significantly higher at the lab 2 compared to the lab 1 (45% vs 30%, p=0.002). Conclusion Oronasal masks are still frequently used by our sleep technologists during CPAP titration studies. There was significant variation in the use of nasal versus oronasal masks by sleep technologists, even between two sleep lab sites that are part of the same institution. An educational program geared toward sleep technologists may reduce the use of oronasal masks during CPAP titration studies which may further improve the adherence to CPAP therapy. Support (if any)
Farishta et al. (Sat,) studied this question.