CPAP is a great treatment for sleep apnea. When people use their CPAP machines, they can be confident that they will get essentially full relief from their sleep apnea symptoms. However, that’s exactly the problem. People often don’t use their CPAP Machines. Even though the machine may be life-saving, it’s uncomfortable and inconvenient, and many people experience adverse effects that may include sensations of claustrophobia or breakouts of acne.
The result of not using CPAP can be ongoing dangers of sleep apnea. Since many studies show compliance rates for CPAP may be as low as 40%, it’s critical to make sure the other 60% of people get more appropriate sleep apnea treatment that can help them get the results they need.
Ideally, we would want to figure out who is a good candidate for CPAP before starting the treatment, so that people can get appropriate treatment first, without having to go through a prolonged trial with CPAP.
Now a new study has looked at the factors that seem to lead to nonadherence to help us predict who is best for CPAP treatment.
Heart Patients Given CPAP
For this study, researchers looked at 357 patients who had experiences acute coronary syndrome (ACS), a label that includes both heart attack and unstable angina. Although these patients were diagnosed with moderate or severe sleep apnea, they didn’t experience daytime sleepiness. These patients were followed for a year, with their compliance tracked, and at the end of the year, researchers looked at the data to see what factors predicted compliance.
They defined compliance as stopping the use of CPAP or using the CPAP machine for an average of less than four hours a night, which is a more restrictive compliance standard than most studies use (at least 4 hours a night on 70% of nights). They found that the compliance rate was only 35.3%. In other words, only about a third of patients actually benefitted from CPAP after a year.
They found that the patients who were most likely to stick with their CPAP were people who had the highest apnea/hypopnea index (AHI), and those who had the longest stay in the Intensive care unit (ICU). This makes sense: people who had the sense that their condition was worse were most likely to stick with the treatment. They also found a surprising correlation: the more a person smoked, the more they were likely to comply with CPAP.
Is CPAP Right for You?
Now that we understand the limitations of CPAP, many doctors and insurance companies are open to starting people on alternate treatments, so if you don’t feel like CPAP is right for you, you should speak up. This study, like others, show that the people most likely to stick with CPAP are those who get the most visible benefits. In addition, it’s important to factor in your personality and other potential reasons for giving up CPAP when considering treatment.