CPAP Might Not Be Worth Trying Again for Dropouts

While CPAP (continuous positive airway pressure) is considered the gold standard for sleep apnea treatment, it has a very high failure rate. The problem is that CPAP is not a very pleasant treatment. It’s uncomfortable and inconvenient for many people. It can be hard to maintain and hard to sleep with.

As a result, many people give up CPAP treatment. Doctors and medical care providers describe them as “CPAP dropouts,” as if the problem is with the people and not with the treatment. Assuming that this is where the problem is, doctors, nurses, and others urge CPAP dropouts to give the treatment another try.

However, there are many people for whom it’s just not worth it to try CPAP again. If CPAP isn’t a good fit for you, you still need sleep apnea treatment, but you should find a CPAP alternative. 

How Many CPAP Dropouts Are There?

Just how many people give up on CPAP treatment? It’s hard to know, in part because of the intellectual dishonesty sometimes employed by CPAP supporters.

Let’s consider a recent study about the 10-year compliance rates of CPAP users. This study reports that only 56/181 patients (30.9%) dropped out of CPAP treatment in 10 years. That seems pretty good, and implies that nearly 70% of patients continued using their CPAP for 10 years. However, in the very next sentence, we find that, in actuality, only 54 (29.8%) patients actually kept using their CPAP for 10 years. In other words, the compliance rate for CPAP over ten years, as they observed it was 49%–less than half. Other studies are less optimistic. This long-term review shows that CPAP compliance might be as low as 34%, or one in three.

Looking at these studies, it’s likely that, for every six people prescribed CPAP, there are three or four dropouts. 

CPAP Failed You

The use of the term CPAP dropout implies that these are people who failed. They gave up on a treatment that was working. However, the sheer numbers of people who just can’t adapt to CPAP shows that it is, in large part, the treatment that fails, not the people.

When CPAP works, it works great, but it is not for everyone–or even most people. CPAP cannot be our only population-wide sleep apnea treatment. When we try to steer CPAP dropouts back to treatment, we shouldn’t be steering them back to CPAP, but to CPAP alternatives.

When Trying CPAP Again Isn’t Worth It

If you have sleep apnea, you need to get it treated. Sleep apnea is dangerous and failure to treat it puts you at serious risk for death in the near future from a number of causes, including heart attack, cancer, stroke, dementia, and car accidents.

However, that doesn’t mean your treatment has to be CPAP. If you already have a CPAP machine and want to give it a try again, go ahead. On the other hand, you might not want to try CPAP again if:

You really tried it
Your CPAP doesn’t work
You need to replace CPAP equipment
You have moderate sleep apnea

Already Tried CPAP

Not everyone gives CPAP a fair try. Some quit before they start or after just a couple weeks. If you gave CPAP a fair try the first time, though, you shouldn’t feel obligated to give it a second try. Giving CPAP a fair try means trying it for more than two months, getting multiple titrations, trying different masks, using CPAP variants like BiPAP, and/or trying CPAP options like heaters and humidifiers. If you’ve gone through that process once, there’s no need for you to do it again.

Broken or Worn CPAP

We don’t know how long you’ve carried around your old CPAP machine, but if it’s so old, worn, or damaged that it doesn’t work anymore, maybe you shouldn’t just buy a new CPAP machine. Instead, it might be time for a different treatment for your sleep apnea.

Expired CPAP Equipment

The CPAP machine is only one part of the expense in getting CPAP treatment. You also have to pay for hoses, masks, humidifiers, and more. These are designed to be replaceable over time as the plastic degrades and becomes inflexible. Replacing all this equipment can be almost as expensive as replacing the CPAP machine. Again, maybe it’s time to consider an alternative to CPAP treatment, rather than try the treatment that failed you once before.

Moderate Sleep Apnea

The truth is that there’s no reason for anyone with moderate sleep apnea to feel obligated to try CPAP. Not the first time, and not again. That’s because CPAP alternative oral appliance therapy works just as well to treat moderate sleep apnea as CPAP. Plus, it’s more comfortable and has better compliance rates.

Get a CPAP Alternative in River Edge, NJ

If you’ve tried CPAP and found it wasn’t for  you, or if you don’t like the thought of trying a treatment that’s only 50% likely to work for you, the River Edge Dental Center for TMJ, Sleep Apnea, & Reconstructive Dentistry can help. Sleep dentist Dr. Marlen Martirossian has extensive training in treating sleep apnea with oral appliances. He has helped hundreds of people from New Jersey and New York get healthy, deep, restorative sleep every night.

Please call  (201) 343-4044, request a video consultation, or use our online form to make an appointment at our office in River Edge, NJ.