Evidence map›Paper›PMID 27542595›Full record

SynthesisJournal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale2016

Trends in CPAP adherence over twenty years of data collection: a flattened curve.

Brian W Rotenberg, Dorian Murariu, Kenny P Pang

6 registry-linked trialsAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 6 registered trials, which are not on this map. Cited by 352 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
352citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04021550 early_phase1withdrawnnot on this mapstarted 2023, after this paper: background citation

Combined Treatment of Angiotensin Receptor Blocker and Antioxidant Supplementation as a Novel Adjunctive Therapy for 24-hour Blood Pressure Improvement in Obstructive Sleep Apnea

TypeinterventionalSponsorUniversity of British ColumbiaRan2023 to 2026Enrolled0ConditionsObstructive Sleep ApneaArmsContinuous Positive Airway Pressure CPAP, Telmisartan 80mg, Alpha-Lipoic Acid 600mg, Microcrystalline Cellulose
NCT05489562 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Use of Intraoral Suction and Its Effects on Obstructive Sleep Apnea

TypeinterventionalSponsorVA Boston Healthcare SystemRan2023 to 2024Enrolled40ConditionsObstructive Sleep Apnea of AdultArmsIntraoral Suction
NCT06520592 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Using Augmented Reality to Establish and Evaluate the Effectiveness of a Set of Continuous Positive Airway Pressure Care Management Protocol for Obstructive Sleep Apnea Patients

TypeinterventionalSponsorNational Cheng-Kung University HospitalRan2025 to 2026Enrolled60ConditionsAherence, Physical Symptoms, Mental Health, Quality of LifeArmsWith AR guided CPAP therapy
NCT06928766 phase2not yet recruitingnot on this mapstarted 2025, after this paper: background citation

Effects of Eszopiclone and Lemborexant in People With Obstructive Sleep Apnoea (OSA) With a Low Arousal Threshold Who Have Difficulty Maintaining or Falling Asleep (ELOSA): A Double-blind, Placebo-controlled, Randomised, Trial.

TypeinterventionalSponsorFlinders UniversityRan2025 to 2027Enrolled15ConditionsOSA - Obstructive Sleep ApneaArmsEszopiclone 3 mg, Placebo, Lemborexant 10mg
NCT07074288 narecruitingnot on this mapstarted 2025, after this paper: background citation

Obstructive Sleep Apnea Non-PAP Outcomes and Viable Alternatives (OSANOVA): Comparison of Mandibular Advancement Device and Hypoglossal Nerve Stimulation Outcomes

TypeinterventionalSponsorWashington University School of MedicineRan2025 to 2027Enrolled60ConditionsObstructive Sleep ApneaArmsMAD, HGNS
NCT07132307 narecruitingnot on this mapstarted 2025, after this paper: background citation

Reducing Obstructive Sleep Apnea After Hypoglossal Nerve Stimulation Through

TypeinterventionalSponsorWashington University School of MedicineRan2025 to 2027Enrolled30ConditionsObstructive Sleep ApneaArmsMandibular advancement device (MAD)
3 · Its place in the literature

Who cites it

352 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Pooled it
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  5. Effectiveness of mandibular advancement devices in obstructive sleep apnea therapy for East Asian patients: a systematic review and meta-analysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025
    Pooled it
  6. Nocturnal oxygen therapy in obstructive sleep apnoea: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2024
    Pooled it
  7. Pooled it
  8. Virtual consultations for patients with obstructive sleep apnoea: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2022
    Pooled it
  9. Pooled it
  10. Trial
  11. What's leak got to do with it? Association of mask leak and positive airway pressure adherence from the homepap study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026
    Trial
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  18. Gefapixant as a P2X3 receptor antagonist treatment for obstructive sleep apnea: a randomized controlled trial.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024
    Trial
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  20. A randomized, double-blind, placebo-controlled, crossover study of respiratory safety of lemborexant in moderate to severe obstructive sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024
    Trial

292 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Brian W RotenbergDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada.
Dorian MurariuDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada.
Kenny P PangAsia Sleep Centre, Paragon, 290, Orchard Road, Unit 18-04, Singapore, 238859, Singapore. drkpang@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObstructive sleep apnea (OSA) is a common disorder, and continuous airway positive pressure (CPAP) is considered to be the gold standard of therapy. CPAP however is known to have problems with adherence, with many patients eventually abandoning the device. The purpose of this paper is to assess secular trends in CPAP adherence over the long term to see if there have been meaningful improvements in adherence in light of the multiple interventions proposed to do so.

methodsA comprehensive systematic literature review was conducted using the Medline-Ovid, Embase, and Pubmed databases, searching for data regarding CPAP adherence over a twenty year timeframe (1994-2015). Data was assessed for quality and then extracted. The main outcome measure was reported CPAP non-adherence. Secondary outcomes included changes in CPAP non-adherence when comparing short versus long-term, and changes in terms of behavioral counseling.

resultsEighty-two papers met study inclusion/exclusion criteria. The overall CPAP non-adherence rate based on a 7-h/night sleep time that was reported in studies conducted over the twenty year time frame was 34.1 %. There was no significant improvement over the time frame. Behavioral intervention improved adherence rates by ~1 h per night on average.

conclusionsThe rate of CPAP adherence remains persistently low over twenty years worth of reported data. No clinically significant improvement in CPAP adherence was seen even in recent years despite efforts toward behavioral intervention and patient coaching. This low rate of adherence is problematic, and calls into question the concept of CPAP as gold-standard of therapy for OSA.

Indexed as

Patient ComplianceContinuous Positive Airway PressureHumansSleep Apnea, ObstructiveAdherenceCPAPObstructive sleep apneaUvuloplataopharyngoplasty

Identifiers

PMID27542595
PMCPMC4992257

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.