5 Steps to Improving CPAP Adherence

Christopher J. Lettieri, MD


March 06, 2012

In This Article


Obstructive sleep apnea (OSA) has been associated with numerous conditions that affect both quality of life and health.[1,2,3,4] The treatment of choice for most individuals is continuous positive airway pressure (CPAP), which has been shown to decrease obstructive events and improve subjective sleepiness, vigilance, and general productivity.[5] However, despite its well-recognized benefits, CPAP acceptance and adherence remain problematic. About half of patients prescribed CPAP either discontinue the therapy or are nonadherent (≤ 4 hr/night).[6,7,8]

There are numerous patient-, mask-, and pressure-related variables that can negatively affect tolerance of and ultimately adherence to CPAP. Being familiar with the most common problems encountered with CPAP will allow clinicians to identify risks for treatment nonadherence. A step-wise approach during the initiation of therapy and follow-up care can help clinicians implement quick and often simple interventions to foster better use of CPAP or prevent discontinuation of therapy.


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