Abstract Introduction While highly effective, compliance of positive airway pressure (PAP) therapy remains a barrier to treating obstructive sleep apnea (OSA) in many patients. PAP NAP is a brief, reimbursable sleep study, designed to help patients with insomnia and OSA acclimate to PAP therapy. Studies have shown increased utilization after the study. Methods This is a retrospective study at a single institution of patients who underwent a PAP NAP procedure at our sleep laboratory between 2019 and 2022. The electronic medical record and PAP provider interfaces were queried for demographics, medical and sleep history, sleep study data, and PAP usage. Initial follow-up and most recent available follow-up data was collected. Paired t-test was used to compare utilization before and after intervention. Results Twenty-four patients underwent PAP NAP. Average apnea hypopnea index was 34.1 (median 26.3, range 5.3 - 111.6). The average length of PAP NAP was 2 hours 10 minutes (range 50 min - 3 hours 55 minutes). The median initial follow-up time after PAP NAP was 33 days. The median long-term follow-up was 1.2 years. Prior to PAP NAP, 5 patients (20.8%) were compliant with PAP therapy as per Medicare criteria. After PAP NAP, 6 (25%) and 7 (29%) patients were considered compliant at initial and long-term follow-up, respectively. There were statistically significant increases in the percentage of nights with PAP usage at least 4 hours, with mean pre-PAP NAP nights over 4 hours averaging 27% and post-PAP NAP averaging 37% (p=0.02). There was no difference at long term follow-up nor were there significant differences in the percentage of total days used at initial or long-term follow-up. Conclusion While an initial increase in the percentage of nights PAP was used at least 4 hours, this does not represent a clinically meaningful difference as few patients increased usage enough to meet the standards of adequate PAP use, and there was no difference at long term follow up. There may be a role for PAP NAP in patients who are already compliant but have problems with tolerance, mask fit, or high residual disease. This area should be further explored as it was a small portion study. Support (if any)
Creighton et al. (Sat,) studied this question.