Good Start and Reinforcement Necessary for CPAP Compliance


If CPAP therapy starts well, it tends to go well. Researchers essentially confirmed this truism, while also adding that it is necessary to “maintain reinforcing interventions over time” to boost the chances of long term compliance.


The study “Usefulness of reinforcing interventions on continuous positive airway pressure compliance” from Italian researchers followed 40 patients with OSA undergoing counseling and a one-year follow-up on a quarterly basis. Twenty subjects (intervention group) underwent reinforcing interventions with telephone interviews in the first month of therapy, and twenty (control group) remained without reinforcing interventions. The two populations were homogeneous for age, severity of illness and BMI.


“During the first month, intervention group patients showed a higher number of nights with a device use ≥4 hours. Average treatment adherence in the first month (days of therapy with at least 4 hours per night on the total number of days from device delivery) was 77.5% in the intervention group and 55.7% in the control group (p=0.022),” wrote researchers. “At one year the differences between the two groups were not significant.”


Researchers concluded: “Our findings suggest that it is important that adequate time and effort is spent to ensure patient comfort at the time of CPAP therapy start to optimize acceptance and adherence to treatment, and suggest that it is necessary to maintain reinforcing interventions over time. Although we can measure side effects and improve re-attendance, more work is necessary to tailor interventions for early identification of poor users, and especially to look out for patients who do not re-attend at all.

Our experience has confirmed the benefit of a medical, motivational and technical support in the first month. However it was not effective in the long term, suggesting that patients treated with CPAP need to maintain a reinforcement beyond the first month of therapy.”


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