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The association between irregularity in sleep-wake rhythm and CPAP adherence.
Aya Honma1,2, Marina Nohara3, Sato Honma3
1Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan. aya-honma@med.hokudai.ac.jp.
Npj Biological Timing and Sleep
|March 3, 2026
Summary
Irregular sleep-wake rhythms and inconsistent sleep onset are linked to continuous positive airway pressure (CPAP) withdrawal in obstructive sleep apnea patients. Addressing these rhythms may improve CPAP adherence.
Area of Science:
- Sleep Medicine
- Chronobiology
- Respiratory Medicine
Background:
- Obstructive sleep apnea (OSA) is a common condition requiring treatment like continuous positive airway pressure (CPAP).
- CPAP adherence is crucial for treatment efficacy but remains a challenge for many patients.
- Understanding factors influencing CPAP adherence is vital for improving patient outcomes.
Purpose of the Study:
- To investigate the association between sleep-wake rhythm regularity and CPAP adherence in newly diagnosed OSA patients.
- To identify potential predictors of CPAP withdrawal based on sleep-wake patterns.
Main Methods:
- Retrospective analysis of sleep-wake rhythms using activity monitoring and CPAP adherence data.
- Study included 45 newly diagnosed OSA patients treated with CPAP at Sapporo Hanazono Hospital (Jan 2018 - Jun 2022).
- Patients were categorized into CPAP withdrawal, good-adherence, and poor-adherence groups.
Main Results:
- No significant differences in apnea-hypopnea index (AHI), sleep efficiency, or subjective sleep quality were found between groups.
- The CPAP withdrawal group exhibited higher variability in sleep onset compared to the good-adherence group.
- Lower regularity and/or amplitude in circadian activity rhythm were observed in patients who withdrew from CPAP therapy.
Conclusions:
- Irregularities in sleep onset and a dampened circadian activity rhythm are potential risk factors for CPAP withdrawal in OSA patients.
- These findings suggest that interventions targeting sleep-wake rhythm regularity may enhance CPAP adherence.
- Further research into chronobiological factors could lead to improved management strategies for OSA.
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