Obstructive sleep apnea

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Obstructive sleep apnea

Can special support improve the use of CPAP therapy?

Photo of a doctor talking to a patient

Psychological and practical support can help people to stick to therapy and also use the machines for longer at night. It is not known how this intensive support affects the symptoms.

People with obstructive sleep snore heavily and experience longer phases of shallow breathing (hypopnea) and breathing pauses () when they sleep. This happens because their airways narrow and sometimes become completely blocked when they lie down to relax. Snoring itself is harmless; but breathing pauses can wake you up and keep you from getting a good night’s sleep.

What CPAP therapy involves

The most common treatment for sleep is 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 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. 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 machine. Many only wear the mask for a few hours at night or stop the treatment altogether.

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

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

Research on support measures

Researchers from the (an international research network) wanted to find out whether people who have obstructive sleep use 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 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 machine.
  • Behavioral interventions to increase the use of 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 symptoms and were using the machine for the first time.

Good to know

The main aim of behavioral interventions is to increase your own ability to solve problems or reach goals. It may include things like motivational conversations, regular written feedback or cognitive behavioral therapy.

Support measures can lead to increased use of CPAP

The studies show that all of the tested programs can (to varying degrees) help people to use 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 machines were used each night by about one hour on average.

But the researchers couldn’t find any proof that increasing the use of 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.

Askland K, Wright L, Wozniak DR et al. Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea. Cochrane Database Syst Rev 2020; (4): CD007736.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Can special support improve the use of CPAP therapy?

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Updated on December 19, 2022

Next planned update: 2025

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Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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