Effect of Heated Humidity With Thermosmart™ Compared to an Intranasal Steroid in Improving Compliance and Nasal Symptoms in Patients Using Continuous Positive Airway Pressure

Inclusion Criteria:

• Between the ages of 18-65

• Diagnosis of obstructive sleep apnea (OSA) with apnea/hypopnea index (AHI) > 15/hr

• Currently using CPAP therapy and within 3 weeks to 12 months of initial CPAP titration

• Based on the CPAP nasal symptom questionnaire, a score of at least 3 (sometimes) forat least one of the following nasal symptoms related to their sleep apnea and CPAPusage: nasal congestion, runny nose, sneezing, or nasal irritation

• Willingness to tolerate and continue therapy with nCPAP

• Successfully titrated on nCPAP in a sleep center to a pressure between 6-16 cmH2O

• Willingness to comply and complete study related procedures

• Fluent in the English language

Exclusion Criteria:

• Co-morbid medical condition that is either medically significant and unstable, wouldinterfere with the patient's ability to routinely use CPAP, or is a contraindicationfor use of a nasal steroid

• Women who are pregnant or who may potentially become pregnant during the course of theresearch trial.

• CPAP compliance over the past three weeks at screening > 5 hours/night, suggesting nocompromised CPAP usage due to adverse nasal symptoms

• Wake resting SaO2 < 90%

• Currently using Bi-Level therapy, supplemental oxygen with CPAP therapy, or using apressure outside inclusion criteria

• Currently using a Full-Face mask for CPAP therapy

• Current or prior use of the Fisher Paykel 604 CPAP machine with Thermosmart™ heatedhumidity.

• Patients who were never prescribed a heated humidifier with their CPAP machine (i.e.no humidifier or passover humidifier).

• Intranasal steroid treatment within the previous six months. Patient's currentlytaking intranasal steroid treatment cannot wash-out of steroid treatment to beincluded nor if patients have used nasal steroid treatment while on CPAP therapy

• Current upper airway tract infection, influenza, respiratory infection at time ofscreening or nasal surgery within 90 days of screening

• Prior surgical intervention for obstructive sleep apnea

• Currently taking medications that would be contraindicated to using a nasal steroid.Patients taking hypnotic or wake promoting therapy can participate if they have beenon a stable dose prior to CPAP therapy and willing to maintain current dose asprescribed.

• Shift or rotating shift workers or individuals who routinely cannot contribute atleast 6 hours/night to sleep/attempting therapy

• Additional sleep disorder that would interfere with routine use of CPAP