Nasal continuous positive airway pressure (CPAP) has proven to be the most effective noninvasive form of therapy for obstructive sleep apnea syndrome (OSAS) (1). When used appropriately, it can be highly efficacious in ablating apnea and relieving symptoms of OSAS. Unfortunately, many published research studies have shown that patient compliance with CPAP therapy can be as low as 40% to 50%. And the rate of refusal of CPAP therapy once a patient has been diagnosed can be as high as 24% (2).

First impressions can be everything. Patients often fail therapy within the first month. Even the first week of therapy can be the crucial "make or break" period (3). A patient's introduction to nasal CPAP or Bi-Level therapy can have a great impact on their long-term acceptance of the therapy. Common reasons for noncompliance include poor mask fit and nasal irritation symptoms. Homecare companies can easily provide solutions to both of these problems. Simple interventions such as careful attention to mask fitting can make the difference between success and failure. Additionally, the use of heated humidification has been shown to prevent the increase in nasal airway resistance seen with both room air and cool humidification, thereby markedly improving patient comfort (4,5).

These examples and many others highlight the fact that homecare companies play a key role in improving patient compliance. The physician, the sleep testing company, and the homecare therapist must all help educate the patient on the seriousness of OSAS and the impact it can have on their life. Patients should be taught how the therapy works and why it is being prescribed for them.

Sleep Data prides itself on having established excellent working relationships with physicians, patients and homecare companies. We look forward to speaking with you and exploring how we can work together to foster better patient care.

(back to top)

References
1. American Thoracic Society. Indications and standards for use of nasal continuous positive airway pressure (CPAP) in sleep apnea syndromes. Am J Respir Crit Care Med 1994;150:1738-45.

2. Schweitzer PK, Chambers GW, Birkermeier N. Nasal continuous positive airway pressure (CPAP) compliance at six, twelve and eighteen months. [abstract] Sleep Res 1987;16:186.

3. Weaver TE, Laizner A, Evans L, Maislin G, Chugh D, Lyon K, Smith P, Schwartz A, Redline S, Pack A, Dinges D. An Instrument to Measure Functional Status Outcomes for Disorders of Excessive Sleepiness. Sleep 1997; 20(10): 835-43

4. Richards D, Cistulli R, Unger R, Berrthon-Jones M, Sullivan C. Mouth leak with nasal CPAP increases nasal airway resistance. Aust NZ J Med. 1994;24.480

5. Hayes M, McGregor F, Roberts D, Schroter R, Pride N. Continuous nasal positive airway pressure with a mouth leak: effect on nasal mucous blood flux and nasal geometry. Thorax. 1995;50:1179-1182.