NOCTURNAL POSITIVE PRESSURE VENTILATION VIA NASAL MASK

Abstract
Five patients with chronic respiratory failure from neuromuscular disease and symptomatic worsening noctural hypoventilation were treated with nocturnal ventilation. Home ventilation at night was provided by a volume-cycled positive pressure ventilator attached to a nasal mask originally designed to administer nasal continuous positive airway pressure (CPAP) for obstructive sleep apnea. The device was well tolerated. Symptoms of headache, insomnia/somnolence, and impaired intellectual capacity rapidly disappeared with nocturnal ventilatroy support. Daytime arterial PO2 and PCO2 improved after therapy. There are severl advantages over commonly used, negative pressure devices for nocturnal ventiliation. These include patient synchronization of tidal volume, ease of application, less cumbersome apparatus, more noctural patient mobility, and absence of production of upper airway obstruction.