Symptoms During CPAP Therapy Are the Major Reason for Contacting the Sleep Unit Between Two Routine Contacts

Abstract

Study Objectives:The demand for continuous positive airway pressure (CPAP) therapy outpaces available resources in most health care settings. We sought to evaluate predictors of nonroutine CPAP follow-up visits to improve resource utilization. Methods: We randomly analyzed 1,141 of the 2,446 patients who had received at least 1 year of CPAP therapy. Reasons for contacts, type (routine = R, nonroutine = NR), and mode (face-to-face or not, physician, nurse) were collected. Results: A total of 771 patients were classified R, and 370 NR. Age, profession, and sex did not affect the NR frequency. Symptoms increased the odds ratio for NR 12.1-fold, somnolence 34.8-fold, and suffocation at night 10.4-fold. Patients with nonroutine reasons abandoned CPAP therapy significantly (7.6-fold) more frequently than patients with routine reasons. Conclusions: Symptoms during CPAP therapy predicted the nonroutine contacts well. In line with this, patients with symptoms have become a priority follow-up group, and could constitute the only follow-up policy when dealing with insufficient medical resources.

Restarting CPAP Therapy for Sleep Apnea After a Previous Failure

“…We previously described that CPAP therapy in Finland is fully subsidized by public health insurance. 10 This may suggest that patients are willing to re-initiate CPAP therapy after previous failure with a lower degree of motivation than if the therapy were not fully insured. No data on CPAP pressure levels were reported.…”

“…Thereafter, follow-up contacts were routinely planned annually. 10 We used ResMed autoCPAP devices (Resmed, San Diego, California). In 2014, humidification was integrated into the Resmed CPAP device.…”

“…If the patient forgoes treatment, he or she must return the device to the clinic. 10 Once CPAP therapy is initiated, there is no requirement by the national insurance for a regular prescription renewal by the physician. The national CPAP instructions recommend a regular follow-up with a physician or nurse.…”

Adherence to CPAP therapy for sleep apnea in patients aged over 70 years old

“…We applied the same criteria for CPAP initiation as described previously [ 11 ] (REI ≥ 15 events/h or REI ≥ 5 events/h if the patient had daytime hypersomnolence or significant comorbidities).…”

Changes in the societal burden caused by sleep apnoea in Finland from 1996 to 2018: A national registry study

“… 32 On the other hand, a third of patients with routine appointments contact health care professionals between the routine appointments. 33 It is generally assumed in Finland that CPAP follow up should be intensified during the first year of CPAP therapy. However, when CPAP treatment is successful after 1 year, 32 it remains unclear if routine follow up is necessary or if on-demand follow-up visits are a suitable alternative for those who need it.…”