Humidification during continuous positive airway pressure therapy.

The study by Massie et al1 has, for the first time, presented scientific proof that the prophylactic application of a humidifier as an accessory in continuous positive airway pressure (CPAP) therapy can improve not only patient compliance and comfort during treatment, but also the results of the treatment. We consider the study to be of particular importance because it shows that we now have to rethink the current clinical practice of using humidifiers as accessories only when patients undergoing CPAP treatment encounter such problems as, for example, drying out of the upper airways. In their “Discussion” section, the authors maintain that their study is the first to show the effect of humidification on side effects and compliance in obstructive sleep apnea (OSA) patients using CPAP (page 408, lines 34–36). However, our own working group had already published a prospective study on OSA patients experiencing side effects of CPAP treatment (January 1999),2 in whom the use of a heated humidifier (incidentally, the same make as in the study of Massie et al) both lowered the rate of side effects and improved patient compliance and comfort under treatment. In addition, we were also able to show that the use of a heated humidifier can reduce the number of patients who abandon CPAP treatment because of the above-mentioned side effects.2 The results published by Massie et al are in good agreement with our own data, and taken together, our findings now demonstrate the clinical efficacy of heated humidifiers used as accessories in CPAP treatment in terms of improving compliance and treatment comfort as well as the results of treatment.