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When to Treat with CPAP and How to Define Success

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CPAP Adherence

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Abstract

Continuous positive airway pressure (CPAP) is currently the most effective treatment for obstructive sleep apnea (OSA) and is considered the “gold standard” for patient care. The most common indications for treatment are excessive daytime sleepiness, disruption in sleep quality, and reduction in overall quality of life. In addition, CPAP is used to treat OSA-related cognitive impairment and depressed mood. In a number of chronic medical conditions such as hypertension, type 2 diabetes mellitus, and coronary artery disease, OSA is considered an independent risk factor for their development. Use of CPAP may be indicated in these conditions to prevent their development or mitigate their severity. Treatment success with CPAP can be defined on the basis of both subjective improvement in symptoms and objective evidence of adherence to therapy. Current definitions of adequate adherence to CPAP treatment may be somewhat arbitrary. For individual patients, both subjective and objective data should be used to conclude whether CPAP treatment has been successful.

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Abbreviations

AF:

Atrial fibrillation

AHI:

Apnea-hypopnea index

APAP:

Auto-adjusting continuous positive airway pressure

ASV:

Adaptive servo ventilation

BP:

Blood pressure

BPAP:

Bi-level positive airway pressure

CAD:

Coronary artery disease

CHF:

Congestive heart failure

CMS:

Centers for Medicare and Medicaid Services

CPAP:

Continuous positive airway pressure

CVD:

Cardiovascular disease

ESS:

Epworth Sleepiness Scale

FOSQ:

Functional Outcomes of Sleep Questionnaire

LVEF:

Left ventricular ejection fraction

OSA:

Obstructive sleep apnea

QoL:

Quality of life

SAQLI:

Sleep Apnea Quality of Life Index

SF36:

Medical Outcomes Study Short-Form Health Survey

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Authors and Affiliations

  1. Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA

    Olabimpe Fashanu & Stuart F. Quan

  2. Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA

    Olabimpe Fashanu & Stuart F. Quan

  3. Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA

    Stuart F. Quan

  4. Edson College of Nursing and Health Innovation, Arizona State University, Tempe, AZ, USA

    Stuart F. Quan

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  1. Olabimpe Fashanu
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Correspondence to Stuart F. Quan .

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Editors and Affiliations

  1. University of Toronto, Toronto, ON, Canada

    Colin M. Shapiro

  2. Maple Leaf Medical Clinic, Toronto, ON, Canada

    Meenakshi Gupta

  3. Sleep on the Bay, Toronto, ON, Canada

    Dora Zalai

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Fashanu, O., Quan, S.F. (2022). When to Treat with CPAP and How to Define Success. In: Shapiro, C.M., Gupta, M., Zalai, D. (eds) CPAP Adherence. Springer, Cham. https://doi.org/10.1007/978-3-030-93146-9_1

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