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