Assessing Therapeutic Response
2. Assess the patient’s response to therapy.
Follow-up assessments are essential to identifying potential barriers to effective therapy, optimizing the therapeutic response, achieving better outcomes, and promoting adherence to CPAP. Asking patients to describe how they feel now as compared with how they felt before CPAP therapy can help them realize the benefits and help clinicians identify factors that may be impairing the therapeutic response.
Ask patients about sleep quality and continuity when using CPAP. Waking up during the night, nocturia, and restless sleep may indicate mask leaks or residual sleep apnea. Some awakening is normal, and not all sleep fragmentation is due to residual OSA. Identifying other potential causes of nocturnal arousals may be required.
Ask patients if they have residual sleepiness. Residual sleepiness is common in OSA and is often due to poor adherence with therapy or insufficient sleep. The primary goal is to promote 100% adherence to CPAP and ensure that the patient obtains a sufficient amount of sleep each night (>7 hr/night). Persistent sleepiness can result from inadequately treated OSA (residual apneic events) or the effect of other medical conditions or medications. Occasionally, OSA may cause persistent sleepiness despite adequate CPAP use and total sleep time.
Medscape Pulmonary Medicine © 2012
Cite this: Christopher J. Lettieri. 5 Steps to Improving CPAP Adherence - Medscape - Mar 06, 2012.