Restarting CPAP Therapy for Sleep Apnea After a Previous Failure

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Main idea: The percentage of subjects who stayed on CPAP therapy after 1 year was significantly reduced when CPAP was re-initiated compared to the control group. CPAP acceptance after re-initiation was higher among men than women. Further studies are necessary to explain this gender difference.

Abstract

About one third of patients fail their first CPAP trial due to several factors. Despite its clinical importance, data on the success of CPAP re-initiation are scarce.

Methods: Of the 6,231 patients referred to our sleep unit for sleep apnea, we included 224 subjects referred for re-initiation of CPAP therapy (re-CPAP). The control group consisted of 228 CPAP-naïve subjects referred for CPAP initiation. Data on subject characteristics, sleep study, and CPAP outcome were collected.

Results: The re-CPAP group had more severe apnea than the control group. After at least 1 year of CPAP therapy, 52% of the re-CPAP group stayed on therapy; this was significantly lower than the 67% adherence for the control group. No gender difference was observed in the control group, whereas women in the re-CPAP group remained on therapy significantly less than men.

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