Symptoms During CPAP Therapy Are the Major Reason for Contacting the Sleep Unit Between Two Routine Contacts

Abstract

Study objectives: The demand for continuous positive airway pressure (CPAP) therapy outpaces available resources in most health care settings. We sought to evaluate predictors of nonroutine CPAP follow-up visits to improve resource utilization.

Methods: We randomly analyzed 1,141 of the 2,446 patients who had received at least 1 year of CPAP therapy. Reasons for contacts, type (routine = R, nonroutine = NR), and mode (face-to-face or not, physician, nurse) were collected.

Results: A total of 771 patients were classified R, and 370 NR. Age, profession, and sex did not affect the NR frequency. Symptoms increased the odds ratio for NR 12.1-fold, somnolence 34.8-fold, and suffocation at night 10.4-fold. Patients with nonroutine reasons abandoned CPAP therapy significantly (7.6-fold) more frequently than patients with routine reasons.

Conclusions: Symptoms during CPAP therapy predicted the nonroutine contacts well. In line with this, patients with symptoms have become a priority follow-up group, and could constitute the only follow-up policy when dealing with insufficient medical resources.

Keywords: APAP; CPAP; follow-up; health care policy; outpatient; sleep apnea.

© 2019 American Academy of Sleep Medicine.

Figures

Figure 1. Flowchart of the organization of CPAP follow-up after 1 year from CPAP initiation.

CPAP = continuous positive airway pressure.

Figure 2. Distribution of routine and nonroutine contacts among different follow-up groups.

Figure 3. Reasons and description of symptoms for nonroutine contacts.

CPAP = continuous positive airway pressure.