Can special support improve the use of CPAP therapy?

The most common treatment for sleep apnea is CPAP therapy, which involves wearing a breathing mask when you’re asleep. The mask is connected through a tube to a small respirator that continually pumps pressurized air into the airways. This keeps the airways open, making it easier to breathe and reducing snoring. Studies show that people who use CPAP therapy are less tired during the day and have a better quality of life.

Wearing the mask takes some getting used to, and some people find it uncomfortable and restrictive. CPAP therapy may cause a blocked nose or a dry throat. Also, the valve of the mask makes some low-level noise, which can disturb sleep at night. So some people will have problems getting used to a CPAP machine. Many only wear the mask for a few hours at night or stop the treatment altogether.

For the treatment to be effective, CPAP machines should be used for at least five hours each night. Some people use the CPAP machine for less than four hours each night, which might not relieve their symptoms enough.

Breathing therapy with a CPAP mask is the most effective treatment for reducing obstructive sleep apnea. Because of this, it’s worth trying to find ways to make CPAP therapy work for you.

Researchers from the Cochrane Collaboration (an international research network) wanted to find out whether people who have obstructive sleep apnea use CPAP therapy more regularly and for longer if they are given special support. They analyzed studies involving participants who took part in special support programs as well as having the usual treatment. The researchers compared two groups of participants: those who had extra support, and those who did not.

They looked at the effectiveness of the following measures:

• In-depth patient education about CPAP therapy, showing people how to use the machine.
• Long-term support from a specific person such as a doctor or nurse – for instance, to discuss how to deal with problems that arise when using the CPAP machine.
• Behavioral interventions to increase the use of CPAP therapy.
• A combination of several of these measures.

The researchers analyzed 41 studies involving more than 9,000 people. Most of the participants had severe sleep apnea symptoms and were using the CPAP machine for the first time.

The studies show that all of the tested programs can (to varying degrees) help people to use CPAP machines more often or for a longer time at night. The support measures – particularly the behavioral interventions and long-term support from doctors or nurses – increased the time that CPAP machines were used each night by about one hour on average.

But the researchers couldn’t find any proof that increasing the use of CPAP therapy also has a positive effect on quality of life – for instance, on tiredness the following day. The studies didn’t look into this aspect enough, so more research is needed here.