{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T14:36:06Z","timestamp":1789914966132,"version":"4.0.1"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,9,6]],"date-time":"2018-09-06T00:00:00Z","timestamp":1536192000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and objective<\/jats:title><jats:p>A major challenge with the treatment of obstructive sleep apnoea (OSA) is adherence to continuous positive airway pressure (CPAP) therapy. Mask tolerability is an important determinant of adherence, however evidence to guide selection of mask interfaces is lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a randomized crossover trial of mask interfaces in CPAP therapy for moderate\u2010to\u2010severe OSA to assess adherence and efficacy of CPAP therapy with nasal mask, nasal pillow and oronasal masks. Demographic data, Nasal Obstruction Symptom Evaluation (NOSE) scores and craniofacial measurements were also analysed for associations with adherence with oronasal masks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010five patients were included in the study (mean\u2009\u00b1\u2009SD age: 46\u2009\u00b1\u200912\u2009years; body mass index: 29.9\u2009\u00b1\u20095.6\u2009kg\/m<jats:sup>2<\/jats:sup>; apnoea\u2013hypopnoea index (AHI): 53.6\u2009\u00b1\u200924.0 events\/h). Patients had better adherence with nasal masks (average night use: 3.96\u2009\u00b1\u20092.26\u2009h\/night) compared to oronasal masks (3.26\u2009\u00b1\u20092.18\u2009h\/night, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and nasal pillows (3.48\u2009\u00b1\u20092.20\u2009h\/night, <jats:italic>P<\/jats:italic>\u2009=\u20090.007). Residual AHI was higher with oronasal masks (7.2\u2009\u00b1\u20095.2) compared to nasal masks (4.0\u2009\u00b1\u20094.2, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and nasal pillows (4.1\u2009\u00b1\u20093.3, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Twenty\u2010two (25.9%) patients had the best adherence with oronasal masks (4.22\u2009\u00b1\u20092.14 vs 2.93\u2009\u00b1\u20092.12\u2009h\/night, <jats:italic>P<\/jats:italic>\u2009=\u20090.016). These patients had lower NOSE scores (15 (0\u201335) vs 40 (10\u201355), <jats:italic>P<\/jats:italic>\u2009=\u20090.024) and larger menton\u2010labrale inferioris\/biocular width ratios (31\u2009\u00b1\u20093% vs 28\u2009\u00b1\u20094%, <jats:italic>P<\/jats:italic>\u2009=\u20090.019).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Nasal masks are the preferred interface during CPAP initiation. Patients with less nasal obstruction and a proportionally increased chin\u2010lower lip distance to mid\u2010face width may have better CPAP adherence with an oronasal mask interface.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.13396","type":"journal-article","created":{"date-parts":[[2018,9,6]],"date-time":"2018-09-06T23:54:55Z","timestamp":1536278095000},"page":"278-285","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Choosing the right mask for your Asian patient with sleep apnoea: A randomized, crossover trial of CPAP interfaces"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2656-0543","authenticated-orcid":false,"given":"Ken Junyang","family":"Goh","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui Ya","family":"Soh","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Singapore General Hospital  Singapore"},{"name":"Sleep Disorder Unit Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leong Chai","family":"Leow","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Singapore General Hospital  Singapore"},{"name":"Sleep Disorder Unit Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song Tar","family":"Toh","sequence":"additional","affiliation":[{"name":"Sleep Disorder Unit Singapore General Hospital  Singapore"},{"name":"Department of Otolaryngology Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei Rong","family":"Song","sequence":"additional","affiliation":[{"name":"Sleep Disorder Unit Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Hao","sequence":"additional","affiliation":[{"name":"Health Services Research Unit (HSRU), Division of Medicine Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken Cheah Hooi","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gan Liang","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thun How","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Singapore General Hospital  Singapore"},{"name":"Sleep Disorder Unit Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(81)92140-1"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/34.1.111"},{"key":"e_1_2_8_4_1","first-page":"CD001106","article-title":"Continuous positive airways pressure for obstructive sleep apnoea in adults","author":"Giles TL","year":"2006","journal-title":"Cochrane Database Syst. 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