If you are newly diagnosed with obstructive sleep apnea (OSA) or think you might have OSA and are preparing for a consultation, you’ve probably started to think quite a bit about CPAP therapy. It’s the gold standard in OSA treatment at The Insomnia and Sleep Institute of Arizona and around the globe. A recent ResMed analysis that surveyed French insurance data reported findings at the annual European Respiratory Society (ERS) International Congress. The report found that those who used CPAP therapy were 39% more likely to survive than those who did not. Currently, the study is not yet peer-reviewed or published.

This analysis followed a Health and Human Service (HHS) review many months ago that suggested CPAP therapy might not be as effective as it seems (after reviewing 47 case studies). The Agency for Healthcare Research and Quality supported this claim, stating that the current evidence “mostly does not support” a connection between CPAP treatment and critical, long-term help with OSA. Now, a final report is due by the end of the year that might have major implications for CPAP makers.

Unpacking CPAP Study Findings

There are (and have been for many years) countless studies that support the efficacy of CPAP therapy for treating OSA. That’s why CPAP has long been the preferred treatment for OSA not just by sleep specialists, but also OSA patients. The request for this final report ultimately challenges the long-held view that CPAP treatment is effective in treating many, if not most, OSA patients.

The review that cast doubt on CPAP success included 12 randomized controlled studies alongside 13 non-randomized comparative studies. It showed that there was “insufficient evidence” to analyze the connection to cardiovascular death and little evidence that CPAP minimizes mortality risk. However, the ResMed abstract refutes this (as do many other previous studies). The ResMed paper was one of 14 presented to the ERS and began by agreeing that the review “failed to demonstrate any beneficial effect of [CPAP] therapy.” However, the problem with the review is that there were “significant limitations,” ranging from who the patients were to the relatively low mortality events as well as “CPAP adherence.”

The Issue of CPAP Adherence

It has long been known that patients not using CPAP machines correctly or routinely, or having ill-fitting equipment, are the major factor in subpar CPAP success. Today’s CPAP supplies and equipment are innovative and highly customizable. Of course, if the equipment is not comfortable, it will probably not be used regularly and correctly. That’s why it’s critical to work with a sleep specialist who can ensure proper fit and modifications or updates of CPAP equipment when necessary.

The ResMed vice president for medical affairs, Adam Benjafield, argues that not treating OSA with CPAP “exposes people to a significantly higher risk of dying for any reason.” Further, the French analysis funded by ResMed, which included over 176,000 people with OSA and conducted over three years, found that the survival rate difference is “significant,” particularly when considering the person’s health, age, other conditions, and cause of death.

What This Means for Your OSA Treatment

Studies that focus on treating sleep apnea are vast, and overall the evidence shows that CPAP can help those with OSA live longer. It is important to note that many adults diagnosed with OSA have co-morbidities that also benefit from treatment, such as hypertension, obesity, and diabetes. These conditions might be directly connected to OSA or may exacerbate it, but do not negate the need for OSA management.

If you or your child has OSA, treatment is needed. CPAP therapy is the standardized treatment plan and effective for most patients. However, for the rare patient who tries CPAP and finds that treatment fails, an implant may be suitable. CPAP therapy is required prior to being considered for an implant, but The Insomnia and Sleep Institute does work with patients on both treatment plans. If you would like to know more about getting help with OSA, or getting an initial diagnosis, contact the office today. Call The Insomnia and Sleep Institute or complete the online form.