We know that CPAP has the potential to be the perfect sleep apnea treatment. When people use their CPAP machines, they can see 100% improvement in their sleep apnea. For many people, CPAP completely eliminates sleep apnea.
But there’s a flaw in this otherwise perfect treatment: people don’t use it. Many people find CPAP to be uncomfortable, confining, and cumbersome. As a result, these people essentially end up with no sleep apnea treatment, which means that they are at risk for the serious dangers of sleep apnea.
Now a new study shows that the people least likely to comply with CPAP treatment are those who have hypertension or atrial fibrillation. In other words, the people who are already suffering the ill effects of sleep apnea are those least likely to benefit from CPAP.
Retrospective Chart Review
For this study, researchers looked at the charts of patients who had been prescribed CPAP for their obstructive sleep apnea. To be included in the study, patients had to have undergone a sleep study to confirm the diagnosis of sleep apnea. The initial study pool was 450 patients who visited a sleep clinic at the hospital, but after excluding patients who didn’t meet the requirements, only 42 qualified.
The compliance requirements for CPAP was the standard of at least 4 hours a night on 70% of nights. Of the patients reviewed, only 55% had compliance with the standard, although 67% of patients did try to use their CPAP on at least 70% of nights.
They found that poor compliance with CPAP was correlated with three factors:
- Hypertension
- Atrial fibrillation (although not a statistically significant correlation)
- Higher leakage from mask
These factors made people less likely to be compliant with their CPAP treatments. The only correlation with good compliance was moderate sleep apnea.
Limitations of the Study
This study was presented at a scholarly conference, so it hasn’t undergone full peer review. Therefore, we have to regard its findings as tentative at this point. The weakness of the findings is accentuated by the small study population that met the inclusion criteria. It’s hard to make firm conclusions based on that few people in a study.
But the findings do reinforce other studies showing that people who need CPAP often have poor compliance rates . And that those poor compliance rates ultimately end up hurting people who need treatment.
How to Address the Problem of Poor Compliance
There are two primary approaches to solving the problem of CPAP compliance. The first is using strategies that can increase compliance. There are a number of these approaches out there, such as couples therapy and telemonitoring, and some of them show real promise. This is ideal for people, especially heart attack patients, who may have central as well as obstructive sleep apnea.
But for people with mostly obstructive sleep apnea, it may be better to propose alternatives to CPAP that have higher compliance, such as oral appliance therapy. For some patients, these devices can be real lifesavers.
If you have been prescribed CPAP in Omaha, but you’re finding it hard to comply with your treatment, we can help. Please call (402) 493-4175 today for an appointment with a sleep dentist at the Advanced Dental Sleep Treatment Center.
