Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 1;17(1):31-36.
doi: 10.5664/jcsm.8786.

Positive airway pressure therapy supplied by an integrated sleep practice associated with greater adherence among pre-Medicare-aged patients with sleep-disordered breathing

James M Andry Jr  1 , Gabriel Toban  2 , Cynthia Chafin  2 , William Noah  3
Affiliations

Positive airway pressure therapy supplied by an integrated sleep practice associated with greater adherence among pre-Medicare-aged patients with sleep-disordered breathing

James M Andry Jr et al. J Clin Sleep Med. .

Abstract

Study objectives: We investigated whether patient adherence to positive airway pressure (PAP) therapy was significantly different between groups whose PAP machines were dispensed by a traditional durable medical equipment (DME) supplier (DME group) versus those provided directly by an integrated sleep practice (ISP group).

Methods: This was a retrospective cohort study that analyzed 3884 patients (ages 18-64) who were set up with a new PAP machine for sleep-disordered breathing. The channel through which PAP therapy was dispensed (DME vs ISP) was chosen as part of the natural course of treatment, making patient choice and third-party payor likely important selection factors. We analyzed whether the groups had significant differences in adherence rates and nightly usage duration after 30 days, 90 days, and 1 year of therapy.

Results: The ISP group had a significantly higher rate of PAP adherence at 30 days (71% vs 66%; P = .004), 90 days (66% vs 56%; P < .00001), and 1 year (52% vs 33%; P < .00001) following initiation of PAP therapy, relative to the DME group. There was a significantly higher duration of PAP use among the ISP group at 30 days (357 vs 345 minutes; P = .002), 90 days (348 vs 319 minutes; P < .00001), and 1 year (312 vs 164 minutes; P < .00001).

Conclusions: This study suggests improved short- and long-term PAP adherence rates among patients who received PAP therapy through an ISP. As current health care trends drive sleep medicine practices to adopt chronic care management models, further studies are needed to better understand the tradeoffs of receiving PAP through traditional DME providers.

Keywords: CPAP; CPAP usage; adherence; obstructive sleep apnea; positive airway pressure; sleep apnea; sleep-disordered breathing.

PubMed Disclaimer

Conflict of interest statement

This work was performed at the Sleep Centers of Middle Tennessee, Vanderbilt University Medical Center, Middle Tennessee State University. The authors report no conflicts of interest.

References

    1. Chai-Coetzer CL, Luo Y-M, Antic NA, et al. . Predictors of long-term adherence to continuous positive airway pressure therapy in patients with obstructive sleep apnea and cardiovascular disease in the SAVE study. Sleep. 2013;36(12):1929–1937. 10.5665/sleep.3232 - DOI - PMC - PubMed
    1. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365(9464):1046–1053. 10.1016/S0140-6736(05)71141-7 - DOI - PubMed
    1. McEvoy RD, Antic NA, Heeley E, et al. .; SAVE Investigators and Coordinators . CPAP for prevention of cardiovascular events in obstructive sleep apnea. N Engl J Med. 2016;375(10):919–931. 10.1056/NEJMoa1606599 - DOI - PubMed
    1. Rotenberg BW, Murariu D, Pang KP. Trends in CPAP adherence over twenty years of data collection: a flattened curve. J Otolaryngol Head Neck Surg. 2016;45(1):43. 10.1186/s40463-016-0156-0 - DOI - PMC - PubMed
    1. Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc. 2008;5(2):173–178. 10.1513/pats.200708-119MG - DOI - PMC - PubMed