0666 Implementing a Sleep Technician Supervised Mask/Interface Fitting Session Can Improve Adherence With Home Automatic Positive Airway Pressure Therapy

Abstract

Listen

Translate article

Abstract Introduction Obstructive sleep apnea (OSA) is a common disorder associated with increased risk of motor vehicle accidents in addition to cardiovascular and neurocognitive comorbidities. Home Automatic Positive Airway Pressure (APAP) therapy is becoming a mainstay treatment of OSA in the outpatient setting. It is typically prescribed without any prior supervised titration. Discomfort related to the APAP interface is thought to contribute to poor adherence with home APAP use. We examined whether implementing a dedicated and personalized interface fitting session improves APAP adherence. Methods After obtaining IRB approval, 132 adult patients newly diagnosed with OSA were prospectively randomized into two groups (Groups A and B). Group A received a personalized interface/mask fitting session supervised by a sleep technician prior to starting home APAP therapy. During this 30-minute session, patients were educated on APAP use and sampled different masks to address any issues with comfort, leaks, etc. Group B received the usual care where they obtained an interface through Durable Medical Equipment. APAP adherence and interface air leaks during the initial 30 days of home APAP use were compared between the two groups. Results Mean APAP adherence during the initial 30 days of APAP therapy was 12.9% higher in Group A compared to Group B; p=0.05. Fewer APAP interface air leaks were present in Group A (14.8 l/min) compared to Group B (21.2 l/min); p=0.04. Conclusion Discomfort related to the APAP interface can quickly lead to non-adherence with APAP therapy. Initial experience of APAP treatment is important in determining subsequent use. Our findings demonstrate that implementing a personalized interface fitting session supervised by a sleep technician can improve APAP adherence. Potential benefits of increased APAP adherence include improvement in quality of sleep and in turn improvement in quality of life. Support Prior studies have shown that the initial experience of APAP treatment was highly important in determining subsequent use. Patients establish a pattern of APAP adherence during the early days of treatment and maintain this pattern long-term. Early intervention with solutions may help improve APAP adherence.