First impressions matter: early CPAP use predicts future success

Abstract

Obstructive sleep apnoea (OSA) is a highly prevalent condition affecting 2 billion adults globally.1 The economic burden of OSA has been reported to be in the billions.2 Continuous positive airway pressure (CPAP) remains the gold standard treatment for OSA.3 The clinical and cost-effectiveness of CPAP depend on patients’ adherence to treatment.4 As many clinicians will recognise, CPAP is often a difficult treatment for patients to tolerate, and published data demonstrate that more than one-third of patients are, in the long run, non-concordant with CPAP treatment.5 Many interventions to increase concordance with CPAP therapy have been investigated, including behaviour therapies such as motivational interviewing,6 management of side effects with interventions such as humidification or different interfaces7 and more recently telemedicine and mobile applications.8 While these interventions have been potentially beneficial in clinical trials, transferability to real-world clinical practice is variable. More recently, the timing of interventions to mitigate poor use has been considered with guidelines advocating follow-up after 1 week, 4–6 weeks and 12 weeks after treatment initiation.9 Dielesen et al 10 in their paper have conducted a study to investigate associations between early CPAP use behaviours …