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Mask-Type Switching Trajectories and CPAP Use in Long-Term Obstructive Sleep Apnoea: The SwitchAdene Real-World
Celia Vidal1, Jean-Pierre Mallet2, Raphaël Gilson3
1IDESP, INSERM, PreMEdical INRIA, Centre Hospitalier Universitaire de Montpellier, Université de Montpellier, Montpellier, France; Groupe Adène, Montpellier, France.
Archivos De Bronconeumologia
|August 12, 2026
Summary
Patients using continuous positive airway pressure (CPAP) therapy who switch mask types, particularly from nasal masks (NMs) to nasal-cradle masks (NCMs), face higher risks of treatment termination. Understanding these mask trajectories is key to improving CPAP adherence.
Area of Science:
- Sleep Medicine
- Respiratory Therapy
- Medical Device Research
Background:
- Continuous positive airway pressure (CPAP) is a primary treatment for obstructive sleep apnea.
- Mask selection and adherence are critical for effective CPAP therapy.
- Long-term mask usage patterns and their impact on treatment outcomes require further investigation.
Purpose of the Study:
- To characterize long-term mask-type trajectories in adult CPAP users.
- To assess the association between mask trajectories and CPAP nonadherence.
- To evaluate the relationship between mask trajectories and CPAP treatment termination.
Main Methods:
- A real-world longitudinal cohort study of newly diagnosed adult CPAP users.
- Analysis of mask usage data across four types: nasal masks (NMs), oronasal masks (ONMs), nasal-cradle masks (NCMs), and intranasal masks (INMs).
- Sequence analysis to identify mask trajectories; multivariable models to assess associations with nonadherence and termination.
Main Results:
- Among 4675 patients, 21.8% were nonadherent and 26.1% terminated treatment.
- Adherent patients changed mask types less frequently than nonadherent or treatment-terminating patients (43.7% vs 50.4% and 53.8%).
- Switching from an initial NM to an ONM, NCM, or INM was associated with increased risk of CPAP termination (ORs ranging from 1.31 to 1.76). NCM renewal specifically was linked to termination (OR, 1.60).
Conclusions:
- Nasal-cradle mask (NCM) renewal is associated with unfavorable CPAP treatment outcomes.
- Switching from nasal masks (NMs) to other mask types, including oronasal masks (ONMs) or nasal-pillow masks (NPMs), correlates with poorer CPAP use.
- Nasal-cradle masks (NCMs) and intranasal masks (INMs) should be distinguished from the broader nasal-pillow mask (NPM) category in clinical practice.