When people use their CPAP machines, they can get great results. They can have peaceful, restorative sleep and can see the mitigation many sleep apnea dangers.
The problem is that many people who are prescribed CPAP just don’t use it. In fact, studies show that 60% or more of people who are prescribed CPAP don’t stick with it long-term. This means that these people aren’t getting treatment, and they are still at risk from their sleep apnea.
Hopefully, we can figure out who these people will be, and if we know they won’t comply with their CPAP treatment, we can redirect them to other treatment options that may be more appropriate.
A new study has tried to do that, looking at the factors that make people more likely to give up on their CPAP treatment so they can be directed to more appropriate treatments and have less time with untreated sleep apnea.
Heart Patients Given CPAP
This study was secondary to a study of serious heart complications. Many members of their population had sleep apnea, and the researchers looked at 357 patients with acute coronary syndrome (ACS). ACS includes both heart attacks and unstable angina. Another wrinkle in the patient population: they were diagnosed with moderate or severe sleep apnea, but they didn’t have daytime sleepiness. All the patients were prescribed CPAP, and were followed for a year to see whether they stuck with their CPAP or not.
This study used a slightly more restrictive definition of CPAP compliance than many studies. Where most studies define CPAP compliance as at least 4 hours use on 70% of nights (an average of at least 2.8 hours a night), this study required that patients must use their CPAP for an average of 4 hours a night.
In absolute terms, only 35.3% of patients were compliant with their CPAP for the year. Just over a third of the patients benefited from CPAP treatment. So, who was it?
The patients most likely to stick to CPAP were those with the most severe sleep apnea, as measured by their apnea/hypopnea index (AHI). They were also more likely to stick to CPAP if they had spent more time in the intensive care unit (ICU). These two make sense: people with more serious conditions are more likely to see the benefit and put more effort into complying with CPAP. An odd correlation was also found: people who smoked more were more likely to stay on CPAP. This may be secondary to having worse health problems.
Is CPAP Right for You?
In the past, it was believed that CPAP was the right treatment for everyone, you had to give CPAP a fair shot first. Now we know that’s not the case. Doctors are open to starting you on treatment other than CPAP. If it doesn’t seem likely that you’re going to stick with CPAP, your doctor is more likely to be receptive to finding you an alternative treatment.
This study, like others, shows that the people who are most likely to stick to CPAP are those who have more severe sleep apnea. You have to see immediate benefit to make CPAP worth it, because the drawbacks of CPAP are immediately obvious. Also take into account other factors that might make CPAP even harder to comply with, such as skin sensitivity and your personality.
If you think that an oral appliance might be a better option for you than CPAP in Omaha, please call (402) 493-4175 today for an appointment with a sleep dentist at the Advanced Dental Sleep Treatment Center.