In patients with neuromuscular disorders, no randomizedstudies have been performed whether nasal or oronasalmasks should be preferred. Oronasal masks are often usedin acute respiratory failure, while nasal masks are preferredin patients with chronic respiratory failure. However, the useof nasal masks can result in mouth leaks with implicationson sleep quality. To reduce these leaks, oronasal maskshave been applied during home noninvasive ventilation(NIV). Until now, upper airway obstruction during NIVhas been thought to be induced by nasal obstruction,pharyngeal collapse, and/or glottis closure. We report acase indicating another cause of upper airway obstruction:use of an oronasal mask can induce obstructive events inthe upper airways, possibly resulting in sleep fragmentationand decreased effi ciency of NIV.
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