We can say without a doubt that CPAP improves not only a sleep apneic patient‘s sleep quality — but also can improve brain perfusion by oxygen - during sleep.
So why do so many predominantly males diagnosed with obstructive sleep apnea (OSA) refuse such easily aable and relatively cheap therapy, when offered a CPAP machine?
Why does sleeping with a CPAP carry with it such a negative connotation? Is it really about discomfort? Because many OSA patients will swear by their CPAP machine and won’t travel far without it, once they get used to it...
Does anyone have any statistics regarding reasons to refuse CPAP therapy? Anecdotal evidence? I would be interested to hear.
Hello Hillel,
There are several studies that discussed the topic, taking into account patient report.
In 1991, Hayes and colleagues (Hayes et at, 1991) investigated the acceptance of CPAP therapy by 95 patients from the general population. The main reasons for noncompliance after the first night of treatment were difficulties in falling asleep with the CPAP mask on and frequent nocturnal awakenings due to discomfort caused by the mask. While the technology has improved since that time, the complexity of the regime remains quite similar, and recent studies continue to report of adherence of approximately 50% of patients (Pelosi et al., 2016)
Please refer to stadies below:
1.Hayes R, Popp W, Wanke T, et al. (1991) Acceptance of CPAP therapy for sleep apnea. Chest 100(4): 1019–1023.
2. Pelosi LB, Silveira ML, Eckeli AL, et al. (2016) The importance of clinical monitoring for compliance with Continuous Positive Airway Pressure. Brazilian Journal of Otorhinolaryngology. Available at: http://dx.doi.org/10.1016/j.bjorl.2016.05.013
I think it it is worse trying to use the mask yourself, to better understand the level of discomfort when the air under pressure is going into your nostrils or oral cavity.
Kind regards,
Tatyana
There certainly is the issue of discomfort; some individuals have much trouble with the trigeminal stimulation induced by the mask, the airway dryness issues, unaesthetic appearance. and the inconvenience of lugging around a device to hotels. However, the real concern for us in the sleep field is that CPAP does little to manage the cardiovascular issues induced by OSA, as outlined in a recent NEJM article. The management is not totally ineffective, but the benefits are minimal. In severe cases of disordered breathing, use of CPAP will support respiration, but the failing blood pressure control results in headaches and following-day feelings of deprivation. We have a task ahead of us to resolve this issue.
I would gladly share some information I have. Feel free to contact me at [email protected]
Some patients refuse CPAP treatment due to local side-effects at the nose or face, or discomfort due to the mask.
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