A comparison of continuous positive airway pressure initiation techniques in the treatment of obstructive sleep apnoea/hypopnoea syndrome in adults

Introduction: This project assesses the differences between CPAP usage, a year after initiation, when patients were introduced to therapy via inpatient respiratory studies, outpatient auto-titration studies or a combination of the two. Methods: The retrospective review of 98 CPAP patients’ usage data was collected and statistically analysed using ANOVA tests, Chi-squared and Kruskal Wallace testing. Results: The findings showed a small clinically significant difference but no statistically significant differences in usage across the three groups (p>0.05). Combining initiation techniques improved yearly CPAP usage by up to 365 hours. The difference between RESP and APAP average usage was 90 hours a year. No statistically significant difference in usage between the three groups was seen. The APAP pathway is the most cost-effective and significantly reduces the time taken to get on to CPAP treatment. Demographic variables are not found to predict nightly usage. All patients increased in weight over the year. Conclusion: The results demonstrate higher levels of usage when combining initiation techniques, indicating initiation with high levels of interaction with healthcare professionals is beneficial. Significant weight gain across all groups poses the moral question of whether CPAP should be issued prior to initial weight loss attempts.