CPAP therapy in OSA – A gap analysis between recommendation and usage

To examine various factors, primarily socioeconomic, psychological, and physiological, which influence the decision of patients diagnosed with obstructive sleep apnea (OSA) to purchase a continuous positive airway pressure (CPAP) device.

The first phase involved 343 patients, undergoing polysomnography (PSG), with informed consent from amongst 1,098 subjects, who presented to a comprehensive Sleep Center in Chennai, India.

Among those diagnosed with OSA, a certain number were recommended CPAP therapy, based on the test results and clinical appropriateness. The second phase involved follow-up of these patients prescribed with CPAP. Patients were interviewed on whether they purchased CPAP devices or not, and the most relevant reasons for their decision.

All 343 subjects who underwent the PSG were diagnosed with varying degrees of OSA. Among them, 291 were recommended to use a CPAP device. 41.9% of patients who were prescribed CPAP purchased the device. Out of these, 84.42% responded that it improved their quality of life and relieved OSA symptoms. Those who did not purchase CPAP, stated reasons such as high device cost (36.69%), deferment due to lack of awareness and education (17.75%), lack of awareness on the cost benefits of the device (11.24%), and discomfort during usage (8.88%).

Patients who used CPAP device report improved quality of life. However, amongst those who did not opt for CPAP therapy, socioeconomic factors appear to be the foremost deterrent followed by other factors such as lack of understanding of the importance of therapy and perceived discomfort with the equipment & interface.