How to Increase CPAP Compliance?

What is CPAP compliance and why is it important?

What is CPAP compliance? CPAP compliance is generally defined by the Centers of Medicare and Medicaid Services (CMS) as using CPAP therapy for an average of 4 hours per night for at least 70% of the nights. National Library of Medicine published studies show that between 29% and 83% of patients do not meet the criteria for CPAP compliance due to removing the CPAP early in the night and/or skipping use altogether. Keep in mind that this definition of 4 hours per night for at least 70% of the nights isn't arbitrary. It is confirmed and shown by research, and it is what it takes to have effective sleep apnea therapy.

Insurance companies usually cover 80% - 90% of the CPAP device (after you cover the deductible). Of course, no insurance company will give away their money…so they are not interested in financing CPAP machine that patient doesn't use, or use at will… thus they use guidelines that define CPAP compliance; besides their specific requirements that they all might have, one of the universal requires is above-mentioned 4 hours per night for at least 70% of the nights.

So, 4 hours per night, 5 nights a week – well that sounds more than doable! For sure it is something that should be a problem for anyone, right? Well, yes, and no. Keep in mind that 4 hours per night, 5 nights a week is an expected minimum! And as we mentioned many times by now, CPAP therapy is challenging and can be very discomforting, up to the point that even long-term users run into struggles or give up at some point.

What are the most common reasons for noncompliance? 

The leading reason for CPAP noncompliance must be the CPAP therapy itself. More precisely, the discomforts that it brings. We wrote before about CPAP therapy discomforts and how to deal with them. Wearing a CPAP Machine Masks for an entire night, breathing forced air, having limited sleep positions, listening CPAP Breathing Machine sounds, maintaining CPAP equipment…there are quite a few potentially discomforting things to get used to, normalize, and accept as a daily routine. Experiencing dry mouth, and/or nasal airways, increased nasal congestion, air swallowing with gastric distension, claustrophobia, pressure irritation, or allergic reactions to face mask materials… Traveling with CPAP is one more challenge that can cause noncompliance…packing a CPAP device and accessories you should/must have on hand (you should always have a cpap cleaner in a bag, especially if you travel for more than 24 hours; we recommend PrimeClean® CPAP Cleaner as a perfect solution for people who often travel, as it comes with its own travel bag!).

Tips for increasing success with CPAP compliance

This one is actually simple…or perhaps it seems simple when considering the discomfort context. By removing the factors causing discomfort noncompliance is reduced, and logically (and effectively) compliance is increased. 

Here are a few tips on how to keep CPAP compliance on the needed level, or increase it…

Educate yourself about CPAP therapy. Before starting with CPAP therapy try to educate yourself about it as much as possible. Have a realistic expectation from CPAP therapy. Knowing what you're facing will prepare you for any possible discomfort or unpleasant situation, and with that you won't be surprised, scarred, or confused about what's going on. Discomfort caused by CPAP therapy might be a shock the first time you use a CPAP machine, put the face mask on, and realize that your sleeping movement is limited by the CPAP tubing… Learning about and understanding the problem is half of the solution to it!

Optimize your sleeping/CPAP conditions. An average adult person sleeps 7 – 8 hours per day. That's a lot of time…and you probably want to spend it as comfortably as possible. If you are having trouble sleeping due to the movement limitation caused by the CPAP face mask and tubing (if you are a side sleeper that is a special issue, then), invest in your comfort - find the best pillow to use with cpap machine! And the Best pillow for sleep apnea (or one of the best) we can recommend is PrimeClean® CPAP Pillow. If CPAP tubing is causing the issue, find some hose management accessories. If dry air is the main problem, use a humidifier… The CPAP industry has developed numerous accessories and solutions that help reduce discomfort and improve the overall CPAP experience. There is a solution for any issue you might experience.

Get the right equipment. One mask doesn't fit all… Sleep Apnea specialists will, according to the patient's diagnosis, prescribe CPAP therapy. CPAP therapy itself can be done with different settings (air pressure, mask type…) and it must be used as prescribed to have full effect. Sometimes, you might feel that the mask you are using is uncomfortable and you just cannot get used to it… With consultations with your physician, you might be able to use some other, more comfortable mask. Air pressure setting is mostly set/prescribed by a physician, and rarely can change (or at least cannot change a lot), but the use of a humidifier, heated hose, muffler, headgear strap covers, and similar “upgraded” CPAP parts can be used freely and contribute to CPAP therapy quality.

Surround yourself with support. At some point, no matter how much time, effort, and money you invest to make it more comfortable, you will feel like it's just too much of a hustle. In those moments you need support from the outside, from a partner, a friend, or a fellow CPAP user. It is especially important to find a "support group" of fellow CPAP users, to understand that it's not happening only to you, and to see that others have overcome the same issues and now look at it as a thing in the past. With modernized communication channels, forums, chat groups, social media groups, and live support groups, it is only a matter of your preference to select what suits you best. The power of understanding and support, although at the bottom of this "tips list", is probably the most important and most potent tool that you can use to improve your CPAP compliance.

CPAP therapy is proven efficient when you do it right

It can be difficult, especially if you are new to the CPAP world. But it can also be rewarding…waking up feeling relaxed, knowing that your sleep apnea cannot cause any harm to your body, knowing that your bed partner can sleep without earplugs…knowing you are doing the right thing, and that the effort is worth it. Living with sleep apnea can be complex and uncomfortable, but (for now) CPAP therapy is the best solution, and as soon as you accept that, it will be easier to do it.