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Unveiling the complexity: predicting long-term CPAP adherence among patients with moderate to severe OSA undergoing
Thomas Antony1, Vishak Acharya K2, Rojina Anna Ray3
1Department of Respiratory Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India. t.antony5@gmail.com.
Sleep & Breathing = Schlaf & Atmung
|October 13, 2025
Summary
A continuous positive airway pressure (CPAP) trial before titration improves patient acceptance and sleep efficiency. This approach may lower CPAP pressures and enhance long-term adherence for moderate to severe obstructive sleep apnea (OSA) patients.
Area of Science:
- Respiratory Medicine
- Sleep Medicine
- Clinical Trials
Background:
- Obstructive sleep apnea (OSA) is a common sleep disorder.
- Continuous positive airway pressure (CPAP) is a primary treatment for OSA.
- Optimizing CPAP titration and patient adherence is crucial for treatment success.
Purpose of the Study:
- To evaluate the impact of a pre-titration CPAP trial on patient acceptability, CPAP pressures, and sleep efficiency.
- To predict long-term adherence to CPAP titration.
- To assess treatment response and determine optimal CPAP pressures.
Main Methods:
- Prospective, randomized, single-center cohort study in India.
- Included patients with moderate to severe OSA diagnosed by polysomnography.
- Excluded patients with hemodynamic instability or psychiatric disorders.
- Assessed CPAP acceptability, sleep efficiency, and mean CPAP pressures post-titration.
- Evaluated anxiety using Beck Anxiety Inventory and CPAP compliance at three months.
Main Results:
- CPAP acceptability was significantly better in the group receiving a pre-titration trial.
- A statistically significant negative correlation was found between acceptability and average CPAP use.
- Sleep efficiency at titration was improved in the pre-titration trial group.
Conclusions:
- A pre-titration CPAP trial can enhance patient acceptability and sleep efficiency.
- This method may lead to lower CPAP pressures.
- Implementing a pre-titration trial could improve long-term adherence in moderate to severe OSA patients.
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