Relationship between OSAS pre-treatment severity and adherence to PAP?

[Shin Ryoku]

I've read in several reviews that overall adherence to PAP therapy for OSAS is poor.  The same is true for treatment of many chronic conditions (diabetes, hypertension, etc).

On the other hand, I would have to guess that someone with severe OSAS symptoms, unable to function in daily life due to extreme hypersomnolence - the kind of person who gets their first "decent" night of sleep in years on the night of their PAP titration study - is likely to have better than typical adherence to treatment.

There are some published data which support this guess: https://link.springer.com/article/10.100...003-0087-7

Does anyone know what the rates of adherence are specifically for people with severe symptoms prior to PAP?  Maybe a lot of those who "give up" are the ones who are in less need of the treatment.  Not to say that there aren't those who would benefit but choose no treatment!

[Cpapian]

Maybe a lot of those who "give up" are the ones who are in less need of the treatment.  Not to say that there aren't those who would benefit but choose no treatment!

100% compliance over last 5+ .  First night slept 10 hours with machine.  Retired with  daytime sleepyness when home alone .  No obvious medical concerns.

Am possibly an exception, but no idea why.

[mhehe]

In my  case your conjecture is correct. I have  been on 100 percent compliance for 20 years even with the early years with horrible masks and noisy machines.

[Gary1of2]

7 months 100% compliance. No naps blood sugars came down, blood pressure down, and also allergies almost stopped all together.

[Apnea Infant]

My case was not severe in that apparently my Apnea was diagnosed as mild to moderate. In fact, the overnight sleep test noted my AHI was 7 but everything collapsed in REM sleep to the extent 20cm H2O was required to open my UA. I reckon that was exacerbated by being a conscientious back sleeper. But my daytime life was grinding to a halt and I had morning headaches regularly in the end before the medical profession took me seriously.

I have been having at least 7-8 hours sleep regularly now albeit I wake often at times. But I just lay back and fall back asleep unless a visit to the loo is required.

So I would agree with you in that I probably would not have persisted if I was not feeling so crap.

[Timur]

I'm interested in this topic. 

I didn't take to this very easily at first.  I had a very serious episode of atrial tachycardia which was linked to OSA and that is why I was sent for a sleep study. I didn't have severe OSA, only moderate, but it was having significant consequences. 

For me, it took months of "getting used to" and making peace with the situation, and some nights I still battle, unfortunately.   If it had not been for the tachycardia episode I doubt I would have continued. I had horrible insomnia both onset and maintenance which made using CPAP very challenging at first. 

I recently found this article quite interesting as it validated my  experience. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5181619/

What kept me motivated to continue is that without a doubt OSA was affecting my cardiovascular health and I know I have to use it everynight. 

So yes, severity of symptoms is probably a strong motivator.

[dracus]

Just about one month in...

100% compliance, except the occasional days where I goto bed late or get up early and the noon compliance cutoff time screws up my hours.

I have had next to zero issues. Use it every time I goto bed.

Ironically enough I'm actually sleeping less now. I wake up refreshed and alert.

I was diagnosed moderate apnea on my back only. I typically sleep on my side though. I wasnt having daytime issues except high BP and obesity.

I just went to rule it out... I was confusing duration with quality. Was surprised at the diagnosis.

At this point, I can't see why I would stop using it. My sleep sometimes is not seemingly as deep but I feel better that I did before.

I was never tired during the day really and thought my mind was clear and sharp. The issue though was as soon as I stopped running around... Boom out like a light.

Now my mind is super sharp and clear so much so I've gone from the thinker to the mad scientist on speed.

Plus I'm having way more dreams,plus the world is a lot brighter.

BP is down, weight is coming off, glucose is normalizing,etc

All this at only one month... I haven't even had my first follow up yet.