Adherence
Long-term CPAP adherence for Obstructive Sleep Apnea (OSA) remains persistently low (~34% non-adherence) over a 20-year period, with no clinically significant improvement despite technological advances and behavioral interventions.
If you have been prescribed CPAP for sleep apnea, be aware that long-term adherence is difficult and typically drops to around 4.5 hours per night for most people, regardless of how new or quiet the machine is. Behavioral support can help add about an hour of use, but it rarely solves the problem entirely. Do not rely on how you feel you are using it; check the machine data. If you cannot tolerate CPAP after trying behavioral strategies, discuss alternative treatments with your provider, as the 'gold standard' label may not apply to your specific case.
The rate of CPAP adherence remains persistently low over twenty years worth of reported data. No clinically significant improvement in CPAP adherence was seen even in recent years despite efforts toward behavioral intervention and patient coaching.
Why this rating
Systematic review of 82 papers over 20 years provides robust secular trend data, though heterogeneity in adherence definitions limits meta-analysis.
Source
Trends in CPAP adherence over twenty years of data collection: A flattened curve
Brian Rotenberg et al. · Journal of Otolaryngology - Head and Neck Surgery · 2016
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