CPAP vs High-Flow Nasal Cannula for Sleep Apnea
(CHOSA Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial explores two treatments for obstructive sleep apnea (OSA) in children. OSA causes breathing to stop and start during sleep, impacting health and daily life. The study compares Continuous Positive Airway Pressure (CPAP), which uses a mask to deliver air and keep airways open, with High-Flow Nasal Cannula (HFNC), which uses soft prongs to deliver warm air and may offer more comfort. Children with moderate-to-severe OSA who struggle with CPAP at night may be suitable candidates for this trial. The researchers aim to determine if HFNC can serve as a comfortable and effective alternative to CPAP. As an unphased trial, this study provides a unique opportunity for children to explore potentially more comfortable treatment options.
Is there any evidence suggesting that this trial's treatments are likely to be safe?
Research has shown that both CPAP and HFNC treatments are generally safe for children with obstructive sleep apnea (OSA). CPAP, used for many years, is effective but can be uncomfortable for some children.
Studies have found that HFNC improves sleep apnea symptoms by reducing the frequency of breathing interruptions during sleep. HFNC delivers warm, moist air through soft nasal prongs, which many find more comfortable than CPAP masks. However, children might not use HFNC as consistently as CPAP.
No major side effects have been reported for either treatment. Both are non-invasive and help keep the airway open during sleep. Overall, both treatments are well-tolerated and aim to improve sleep quality and comfort for children with OSA.12345Why are researchers excited about this trial's treatments?
Researchers are excited about these treatments for sleep apnea because they offer alternative ways to keep airways open during sleep. Continuous Positive Airway Pressure (CPAP) is a well-known method that uses a mask to deliver pressurized air, effectively preventing airway collapse. The High-Flow Nasal Cannula (HFNC) is different because it delivers warmed, humidified air at high flow rates through soft nasal prongs, which might be more comfortable and easier to tolerate for some patients. This trial aims to see if HFNC can be as effective as CPAP, potentially providing a more patient-friendly treatment option for obstructive sleep apnea.
What evidence suggests that this trial's treatments could be effective for obstructive sleep apnea?
This trial will compare Continuous Positive Airway Pressure (CPAP) with High-Flow Nasal Cannula (HFNC) for treating obstructive sleep apnea (OSA). Research has shown that CPAP helps treat OSA by keeping the airway open during sleep, with many children experiencing symptom improvement, although some find it uncomfortable.
Participants in this trial may receive HFNC, which studies suggest could be a good alternative to CPAP, especially for children. HFNC delivers warm, moist air through small tubes in the nose, potentially offering more comfort and ease of use for kids. Research indicates that HFNC can reduce OSA symptoms, though it might not be as effective as CPAP. However, its comfort and ease of use could make it a suitable option for those who have trouble with CPAP.12356Who Is on the Research Team?
Indra Narang
Principal Investigator
The Hospital for Sick Children
Are You a Good Fit for This Trial?
This trial is for children aged 2 to 18 years who have moderate-to-severe obstructive sleep apnea and are not able to be treated with surgery.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants are randomly assigned to use either CPAP or HFNC at home during sleep for 3 months
Follow-up
Participants are monitored for adherence, sleep-related symptoms, and quality of life after treatment
What Are the Treatments Tested in This Trial?
Interventions
- Continuous Positive Airway Pressure (CPAP)
- High Flow Nasal Cannula (HFNC)
Trial Overview
The study compares two home treatments for sleep apnea in children: CPAP, which uses a mask to deliver pressurized air, and High-Flow Nasal Cannula (HFNC), which delivers warm, humidified air through soft nasal prongs. Children are randomly assigned to use one of these treatments during sleep for 3 months.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
Participants assigned to this arm will receive High-Flow Nasal Cannula (HFNC) therapy for the treatment of obstructive sleep apnea. HFNC delivers warmed, humidified air at high flow rates through soft nasal prongs to support airway patency during sleep. Participants will use HFNC at home each night during sleep for a three-month intervention period, with flow settings optimized based on standard clinical care.
Participants assigned to this arm will receive Continuous Positive Airway Pressure (CPAP) therapy for the treatment of obstructive sleep apnea. CPAP delivers pressurized air through a mask worn during sleep to keep the airway open. Participants will use CPAP at home each night during sleep for a three-month intervention period, with device settings optimized based on standard clinical care.
Find a Clinic Near You
Who Is Running the Clinical Trial?
The Hospital for Sick Children
Lead Sponsor
Fisher and Paykel Healthcare
Industry Sponsor
Dr. Justin Vaughan
Fisher and Paykel Healthcare
Chief Medical Officer since 2024
MD from the University of Auckland
Lewis Gradon
Fisher and Paykel Healthcare
Chief Executive Officer since 2016
Bachelor of Science in Physics from the University of Auckland, New Zealand
Citations
Effect of high-flow nasal cannula therapy on adults with ... - PMC
Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder. There has been some evidence that patients with OSA may benefit ...
High Flow Nasal Cannula for Obstructive Sleep Apnea
The ODI under one night transnasal high flow therapy will be compared with one night continuous positive airway pressure. 2 days. Secondary Outcome Measures ...
Efficacy of high-flow nasal cannula therapy and its ...
HFNC is an alternative treatment option with comparable efficacy to CPAP in alleviating disease severity in paediatric patients with MS-OSA.
4.
journals.lww.com
journals.lww.com/md-journal/fulltext/2025/11280/effect_of_high_flow_nasal_cannula_therapy_on.99.aspxEffect of high-flow nasal cannula therapy on adults with...
The pooled analysis revealed that HFNC therapy led to a significant reduction in apnea–hypopnea index (mean difference [MD] = −8.90; 95% ...
5.
ctv.veeva.com
ctv.veeva.com/study/cpap-vs-high-flow-nasal-cannula-for-treating-sleep-apnea-in-childrenCPAP vs High-Flow Nasal Cannula for Treating Sleep Apnea ...
The results are expected to clarify whether HFNC offers a more acceptable or effective alternative for children who struggle with standard CPAP ...
6.
dovepress.com
dovepress.com/high-flow-nasal-oxygen-prolongs-safe-apnea-time-in-obstructive-sleep-a-peer-reviewed-fulltext-article-RMHPHigh-Flow Nasal Oxygen Improves Safe Apnea Time in ...
Results: The HFNO group demonstrated a significantly prolonged safe apnea time compared to the Control group (18.1 [12.1,18.8] vs 4.2 [2.5,6.3] ...
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