![]() ![]() However, some of these patients with referrals probably did not have the chance to evaluate the full spectrum of treatment options. Some of the patients in this study without CPAP or a documented referral must have seen a specialist at some point in time, even if outside the Cleveland Clinic system. Obviously, there is no concerted effort to leave sleep apnea patients without treatment. Their conclusion was that there are gaps in the management of patients with sleep apnea who fail or refuse CPAP. However, that meant that almost half (46%) of the entire group of patients newly diagnosed with sleep apnea were unable to tolerate CPAP and did not receive a referral to a specialist to assess their treatment options. For the 58% who did not do well with CPAP after it was recommended, some (about one-fifth) were referred either to a sleep medicine specialist, otolaryngologist–head and neck surgeon, or dentist. Of the patients who did agree to use CPAP, about 60% were still using it at their last follow up (in some cases 3 years after the initial diagnosis), although that still only represents 42% of the total group. Almost 17% of the patients refused CPAP immediately after their initial exposure to it and never obtained the equipment for use at home. What happens if you hate CPAP?Ī study published in the November 2015 issue of the medical journal Otolaryngology–Head and Neck Surgery examined over 600 patients who were newly diagnosed with obstructive sleep apnea after a sleep study at the Cleveland Clinic over a 2-month period in 2010. These studies ignore those who find CPAP completely intolerable and refuse it immediately, making the true estimate of difficulties with CPAP a little higher than most studies would suggest. Most of these have focused on individuals who wore CPAP during at least part of a night and then indicated they would be willing to use it at home. On the other hand, multiple studies have shown that about half of all patients with sleep apnea are unable to tolerate positive airway pressure therapy (such as CPAP, BPAP/BiPAP, or APAP/AutoPAP). ![]() I had a close friend visiting me last month who offered to be on any public service announcement I might have because he has had such a dramatic improvement with CPAP and has been able to use it comfortably all night, every night. For patients with moderate to severe sleep apnea, CPAP remains the first-line therapy. The answers I give are those that I offer to my own family and friends. Can’t we just do surgery and take care of the problem right away?.How can you expect me to sleep with that mask on my face? You mentioned this mask and treatment called CPAP.If I have sleep apnea, what are my treatment options?.After I explain what sleep apnea is and order a sleep study, they almost always have a few questions: I see patients all the time who are coming in for the first time to see someone for an evaluation of snoring and possible sleep apnea. ![]()
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