ArticleThorax2025
Six early CPAP-usage behavioural patterns determine peak CPAP adherence and permit tailored intervention, in patients with obstructive sleep apnoea.
Article in Thorax, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Implementing sleep apnea care to improve positive airway pressure adherence here and across the pond.American journal of respiratory and critical care medicine · 2026Article
- Therapeutic options for patients with obstructive sleep apnoea: a retrospective review of difficult-to-treat cases in a multidisciplinary approach.BMJ open respiratory research · 2026Article
- Rethinking Long-Term Follow-Up of CPAP Therapy in Obstructive Sleep Apnea: Toward Personalized and Integrated Care.Healthcare (Basel, Switzerland) · 2026Review
- Optimizing CPAP Adherence in Obstructive Sleep Apnea: A Narrative Review of Practical Strategies for Everyday Clinical Care.Healthcare (Basel, Switzerland) · 2026Review
- White Matter Hyperintensity Burden and Short-Interval Change Associated With Sleep Apnoea in the UK Biobank.Annals of clinical and translational neurology · 2026Article
- Adherence to CPAP in Randomized Controlled Trials in Obstructive Sleep Apnoea-A Meta-Analysis and Investigation of Predictors.Journal of clinical medicine · 2026Review
- Beyond the Mask-Psychological Discomfort as a Predictor of Early CPAP Nonadherence in Moderate-to-Severe OSA Patients: A Prospective Mixed-Methods Study.Nursing research and practice · 2026Article
- Article
- Patients' experiences of barriers and facilitators with continuous positive airway pressure therapy in obstructive sleep apnoea - a qualitative interview study.Archives of public health = Archives belges de sante publique · 2025Article
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh rates of non-adherence to continuous positive airway pressure (CPAP) in obstructive sleep apnoea hamper good clinical outcomes. Current recommendations assumes two behaviours (adherence and non-adherence) and days 7-90 follow-up post-CPAP initiation mitigates against non-adherence.
objectivesTo investigate associations between early CPAP-usage behaviours and (1) CPAP adherence at month 3 of treatment and (2) sleep centres' treatment pathways (the procedures patients undergo that may affect barriers or facilitators of CPAP adherence).
methodsWe conducted growth mixture modelling (GMM) on retrospective data from 1000 patients at 5 UK sleep centres. Night 1 to month 3 telemonitored CPAP-usage data were downloaded from 200 patients per centre who started CPAP in 2019 (100) or 2020 (100). Adherence was defined using accepted criteria (mean CPAP-usage ≥4 hours/night for ≥70% of nights).
resultsGMM identified six distinct CPAP-usage behaviour patterns over month 1. In four (54% of patients), CPAP-usage increased or decreased, in two (remaining 46%), CPAP-usage/non-usage was consistent. 62% of the cohort were non-adherent by month 3, despite pathways following current recommendations. 98% of patients who were non-adherent by month 3 were already non-adherent by month 1. Regression analysis with a separate dataset demonstrated that early CPAP-usage behaviour explained 86% of the variance in CPAP non-adherence at month 3.
conclusionsThese data, supported by previous work, indicate that recommended day 30-90 follow-up is too late to prevent CPAP non-adherence. Determining CPAP-usage behavioural pattern in week 2 identifies risk of CPAP non-adherence at month 3 and permits the possibility of tailored interventions.
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