Want to Boost Your Treatment Compliance? Watch Yourself Sleep Without Your CPAP

Photo by Bruno van der Kraan via Unsplash

Want to Boost Your Treatment Compliance? Watch Yourself Sleep Without Your CPAP

By Admin

An interesting study by Mark Aloia, PhD, a sleep expert at the National Jewish Health organization, involved videos of patients struggling to breathe while sleeping without their CPAP. After showing patients the videos of their apneas and other breathing problems, the response was a massive boost in treatment compliance for nearly every participant involved. According to the study, more than half of those prescribed CPAP therapy become noncompliant. While some strategies such as education, ongoing support, and follow-up interventions have helped to increase rates of compliance, the number of patients diagnosed with sleep apnea remains on the rise, and resources are limited in many areas. What this study achieved was an immediate, often shocking method of raising awareness. And the changes were significant for most of those involved. Patients who had previously given up on CPAP now found themselves embracing the treatment not only as a way to sleep better, but as a means of survival.

Watch Yourself

What these patients had in common was an attitude about sleep apnea that minimized its dangers. Studies on CPAP compliance have found that patients who show initial reluctance or have a history of low compliance for other medical treatments are less likely to continue with therapy. This highlights the importance of first impressions and awareness of the dangers involved with untreated sleep apnea. As Dr. Aloia explains, sleep apnea occurs when patients are unconscious or only partly conscious, and they often have no recollection of the experiences, even when they strain and suffer through the events. The patients involved in the video study had assumed their sleep apnea was not as bad as it was. But watching the videos, for many, was a revelation. As with the other participants, John Brugger told doctors he didn’t like wearing his CPAP mask. Like many newly-diagnosed patients, he would take it off during the night, or stop wearing it at all. But a 60-second video captured his body straining to breathe through a collapsed airway, and it made all the difference to him. “Seeing what my body was going through at night,” Mr. Brugger told the doctors, “was a powerful moment.” Even Doctor Aloia, the study’s lead conductor, was surprised by the extent of the turnaround after patients were presented with the videos. On average, patients who had watched videos of themselves during the study used CPAP nearly twice as long as those who didn’t watch a video at all. And some, like Mr. Brugger, planned to use CPAP without exception following the study.

Watching Others

While the study concluded with patients watching themselves, this was not necessarily part of the plan. They initially showed patients videos of other people experiencing sleep apneas. Reactions to these videos were noteworthy as well, but were nowhere near as impactful as videos of their own apnea experiences. The problem, Dr. Aloia realized, was that patients assumed their own conditions were not as bad as those they viewed. This left too much room for denial. When later presented with the stark reality of their own struggles, they were forced to accept the truth. “We really create a sort of a personal sense of urgency,” Dr. Aloia said of his study, “To change their behavior.” Some patients were brought to tears over the truth of their condition, describing it as basically seeing themselves “drowning in bed,” and yet they were informed of their condition at the moment of diagnosis, long before they participated in Dr. Aloia’s study. This gave the researchers the idea of using the videos as a way to bring patients into the diagnostic process and make the sense of urgency clear to them from the beginning.

From Diagnosis to Compliance - Bridging the Gap

PAP therapy compliance is defined by most institutions as an average of 4 hours of therapy a night for at least 70% of the nights involved. Often, newly diagnosed patients fail to meet this criteria. While many learn to use PAP therapy over time, it is also common for new patients to give up early after a bad experience. Studies in the past have shown that interventions and education can make a major difference in the likelihood of the patient adapting to the treatment, but it is difficult for doctors and support networks to monitor patient progress and provide the necessary assistance on a regular basis. On the other hand, Dr. Aloia’s videos seek to add additional urgency to the moment of diagnosis, at a time when patients are at a turning point and need all the encouragement they can get. Reports in recent years have shown no consistent improvements in PAP therapy compliance rates over the last two decades, despite major efforts in the improvement of care, and considerable advancements in PAP therapy technology, making the devices quieter, more comfortable, and easier to set up and navigate to track your own progress. But it’s still too easy to set the machine aside and go to sleep without it, taking a risk that will only worsen over time. In fact, on average, over 30 percent of patients diagnosed with sleep apnea fail to comply with treatment even after CPAP titration in a lab. Left untreated, sleep apnea can also lead to other serious medical conditions, including heart disease, diabetes, and even cancer. Depression, fatigue, memory problems, headaches, sexual dysfunction, and irritability are common among those who suffer from any sleep disorder, but are especially frequent among those who suffer from periodic apnea events during the night. The more immediate, daily consequence of not getting enough sleep is a higher risk of causing an accident, whether driving, riding a bike, or simply walking through the course of your day. It’s estimated more than 20 million Americans have sleep apnea. If you have been diagnosed and feel that your apnea events are less than life threatening, or that you may not need a CPAP device, you may want to consider Dr. Aloia’s message and record yourself while you sleep. The truth, though difficult to watch, could possibly save your life.