Edinburgh Napier University

  Background: The number of patients being referred to sleep services with suspected obstructive sleep apnoea syndrome (OSAS) is increasing. The recent NICE recommendations should promote prompt diagnosis and increased use of continuous positive airway pressure (CPAP) therapy. This study explores patient views on CPAP as a life-long therapy for OSAS.
Methods: Sequential CPAP follow-up patients (1 month, annual or trouble shooting appointments) completed an anonymous questionnaire relating to OSAS and CPAP therapy. The questionnaire covered support and information issues, whether patients consider CPAP a life-long therapy, partner experiences and suggestions for follow-up services.
Results: 75 patients completed the questionnaire (90.3% response rate, 57 men, mean age 53.7 ± 13.1 years). Mean time since starting CPAP was 26.3 months (range 0.25–180). 96% reported that they were given enough support/information when starting CPAP. 74.7% patients acknowledged CPAP to be a life-long therapy. Negative themes that emerged included stigma associated with the mask and apparatus, using CPAP with new partners or sleeping away from home and disturbing partner’s sleep. Positive themes related to improved vitality, better sleep, less daytime sleepiness, partner delight with effects of CPAP and improved sex life. Time taken to get used to CPAP ranged from never (9.3%) to 24.1% taking 1–6 months. Results suggested that annual follow-up encouraged adherence to therapy in 64% and most thought sleep services should offer problem (73.3%) and annual (76%) appointments. Fewer people thought that problem (P) or annual (A) follow-up should be offered by: telephone (P 52%, A 45.3%), or GP (P 37.3%, A 38.7%) or private healthcare (P 28%, A 25.3%). The most common alternatives to CPAP tried were weight loss (60%) and sleeping on the side (70.7%). 18.7% reported they would consider bariatric and 20% mandibular advancement surgery, if appropriate.
Conclusion: This study has highlighted positive and negative themes associated with CPAP use. Whereas the majority of respondents consider CPAP to be a life-long therapy and believe access to follow-up care to be important, some were keen to explore alternatives to CPAP such as bariatric and mandibular advancement surgery. Gaining feedback from patients about CPAP services helps to provide a patient-responsive service.