‘CPAP Intolerance’ Is a Sweeping, Misused Phrase adminJuly 28, 2023 The low four hour/night CPAP usage threshold can become a vicious cycle. Think of it this way: What if oncologists had a highly effective noninvasive treatment for [cancer of your choice] with minimal risk of complications or side effects? Patients self-administered this treatment at home during sleep instead of undergoing daytime radiation or chemotherapy at a medical facility. Would oncologists embrace and encourage such a therapy? Paradoxically, patient advocacy may save sleep medicine from itself. Twenty years ago, it was common to encounter people who “knew” OSA was a hoax. No more. Today, it’s common and, yes, inspiring to encounter people eager to share how nightly nightlong use of CPAP revitalized their lives.—DEW References Janssen HCJP, Venekamp LN, Peeters GAM, et al. Management of insomnia in sleep disordered breathing. Eur Respir Rev. 2019 Oct 9;28(153):190080. Sweetman A, Lack L, Catcheside PG, et al Cognitive and behavioral therapy for insomnia increases the use of continuous positive airway pressure therapy in obstructive sleep apnea participants with comorbid insomnia: a randomized clinical trial. Sleep. 2019 Dec 24;42(12):zsz178. Herrero Babiloni A, De Koninck BP, Beetz G, et al. Sleep and pain: recent insights, mechanisms, and future directions in the investigation of this relationship. J Neural Transm (Vienna). 2020 Apr;127(4):647-60. Chernyak Y. Improving CPAP adherence for obstructive sleep apnea: A practical application primer on CPAP desensitization. MedEdPORTAL. 2020 Sep 15;16:10963. Roy S. What might be obstructive your patient’s CPAP adherence. Sleep Review 2023 March:6-7. 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 Sep 8;375(10):919-31. Pamidi S, Wroblewski K, Stepien M, et al. Eight hours of nightly continuous positive airway pressure treatment of obstructive sleep apnea improves glucose metabolism in patients with prediabetes. A randomized controlled trial. Am J Respir Crit Care Med. 2015 Jul 1;192(1):96-105. Illustration 142582162 © Ratz Attila | Dreamstime.com
