P179 Is trying CPAP for a second time (after giving up previously) worth it?. (12th November 2019)

• Record Type: Journal Article
• Authors: Simmons, CPL; Groves, H; Close, P; Uddin, S; Littlemore, J; Tomlinson, M; Olds, G; West, S
• Is Part Of: Thorax. Volume 74(2019)Supplement 2
• Page Start: A187
• Page End: A187
• Publication Date: 2019-11-12
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax-2019-BTSabstracts2019.322
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Background: Continuous positive airway pressure (CPAP) is a successful treatment for moderate and severe obstructive sleep apnoea (OSA). Patients may return their CPAP machine on account of improvement in symptoms or adverse side effects. Cessation of CPAP can cause recurrence of the initial symptoms of OSA and necessitates a review for consideration of second trial of CPAP. Aim: The aim of this study was to review whether people who have previously tried and returned their CPAP machine are adherent to CPAP following a second trial. Methods: Between September 2016 and April 2019 a prospective study of consecutive patients attending the sleep clinic for consideration of a second trial of CPAP for OSA was performed. Data was collected at the CPAP initiation and review, including adherence and indications for ongoing CPAP treatment. Results: The data for 55 patients (50 male) were analysed. Prior to initial trial of CPAP: mean age 49.1 years (SD 12.5), mean weight 107.9 kg (SD 22.2), mean ESS 11.4 (SD 5.2), mean AHI 28.5/hr (SD 21.5). Patients adhered to their first trial of CPAP for a mean of 57.8 weeks (range 0.3–364 weeks). Seventeen patients (30.9%) noticed symptom improvement after their first trial of CPAP. Reasons for stopping CPAP included problems with mask discomfort, sleep disturbance due to noise from the CPAP machine and claustrophobia. Prior to second re-trial of CPAP: mean weight 107.0 kg (SD 22.7), mean ESS 11.6 (SD 6.3), mean AHI 28.1/hr (SD 14.8). Reasons for patients being reviewed for consideration of a second re-trial of CPAP including mask discomfort were addressed and resolved with equipment modifications. After a second trial, 37 (67%) patients chose to continue with CPAP long term after review (mean 8.3 weeks after initiation). Mean compliance was 5.1 hours after modification of factors affecting adherence. Conclusion: There was ongoing adherence to CPAP in 67% of people following a second trial of CPAP for OSA in patients who had previously returned CPAP. A second trial of CPAP can prove successful and result in long term adherence and is therefore worth it.