Adherence to Positive Airway Therapy After Switching From CPAP to ASV: A Big Data Analysis

Abstract

Treatment-emergent or persistent CSA during CPAP reduced therapy adherence, but adherence improved early after switching from CPAP to ASV.

Partial failure of CPAP treatment for sleep apnoea: Analysis of the French national sleep database

“…Telemonitoring can provide repeated measures of AHI allowing early identification of emergent CSA phenotypes and in the future will permit a real‐time approach to the management of this specific sleep apnoea population. When persistent high residual AHI linked to CSA occurs, and after exclusion of heart failure with reduced ejection fraction, an early switch from CPAP to adapted servo‐ventilation has demonstrated its effectiveness in normalizing AHI and improving adherence. The development of new multifaceted management pathways supported by telemonitoring will require validation in randomized controlled trials (RCT), as has previously been done for other chronic diseases and in particular for cardiac failure …”

Value and limitations of real-world data to understand paediatric adherence to positive airway pressure therapy

“…This approach to data gathering allows clinicians to assess how these devices are used in the home by patients, without the potential biases or changes in behaviour that might be introduced when patients specifically volunteer to be in a research study. 2 Furthermore, the findings appear to have biological plausibility. Adolescents have historically had low adherence to many forms of medical therapy, 3 a notion reinforced in this study.…”

Contemporary Concise Review 2019: Sleep and ventilation

“…showed 75% adherence with CPAP therapy based on US Medicare criteria at 3 months . Several rescue strategies were also examined including the switch to adaptive servoventilation (ASV) therapy or the switch to bi‐level PAP, both of which showed improvement in adherence and/or machine‐detected events after versus prior to switch . Similarly, Ishak et al .…”