What does this research mean for the field?

AI-driven continuous management of airway pressure (cMAP) significantly improves therapy adherence and nightly usage while reducing clinical coaching time compared to standard auto-adjusting positive airway pressure (APAP) in patients with obstructive sleep apnea. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to compare the adherence and sleep-related outcomes of cMAP® versus APAP therapy in patients with obstructive sleep apnea.

May 20, 2026

B80-2-05 Driving Pap Therapy Adherence While Lowering Clinical Resource Burden: A Head-to-Head Analysis of 96 Patients Comparing Cmap® and Apap

Key Points

This study aims to compare the adherence and sleep-related outcomes of cMAP® versus APAP therapy in patients with obstructive sleep apnea.
Double-blind, block-randomized-controlled trial of 96 participants (cMAP®: 50, APAP: 46) with 3-month follow-up.
Primary endpoints included monthly adherence and CMS compliance, analyzed using Fisher’s Exact Test and a generalized mixed-effects model.
Reasons for discontinuation were identified via a standardized questionnaire and compared between groups.
At 3 months, adherence was 66.0% for cMAP® versus 39.1% for APAP (p < 0.05).
CMS compliance was 88.0% for cMAP® compared to 71.7% for APAP (p = 0.07).
Average nightly usage was 5h 22m for cMAP® versus 4h 25m for APAP (p < 0.05), with cMAP® requiring less coach time.

Abstract

Abstract Rationale Despite the efficacy of positive airway pressure (PAP) therapy in treating obstructive sleep apnea (OSA), adherence declines to less than 50% after one year (Bakker 2019, CHEST). However, our group previously showed that a critical barrier to adherence may be discomfort from high air pressure during auto-adjusting (A)-PAP therapy (Hanafi 2024, EurRespirJ). Additionally, elevated therapy pressure may be linked to lung endothelial injury and other cardiovascular risks (Peker 2024, eBioMedicine). Our AI-driven technology, continuous management of airway pressure (cMAP®), delivers effective therapy by predicting and preventing OSA events with an ∼20% reduction in therapy pressure (Hanafi 2024, EurRespirJ). In this study, we compared 3-month and long-term adherence and sleep-related outcomes between cMAP® and APAP. Methods This was a double-blind, block-randomized-controlled trial of 96 participants (cMAP® n = 50, APAP n = 46) with 3-months follow-up. Primary endpoints were monthly adherence and Centers for Medicare 0.05), and higher CMS compliance (88.0% 44/50 vs. 71.7% 33/46, p = 0.07). After adjusting for confounders (via GMM), 3-month adherence (p 0.01) and CMS Compliance (p 0.05) were significant. Despite similar diagnosis sleep duration, cMAP® showed significantly higher average nightly usage (5h 22m vs. 4h 25m, p 0.05) and required less total coaching time (19.3 ± 13.0m vs. 40.6 ± 28.8m, p 0.01) than APAP. The most prominent reason for discontinuing, “CPAP wakes me up too often”, was cited exclusively by APAP patients (N = 12, or 71% of that group’s discontinuers, p 0.05). Additionally, preliminary 9-month data showed a persistent adherence gap (cMAP®: 67% 16/24 vs. APAP: 24% 5/21, p 0.05). Conclusions AI-driven cMAP® delivered improved adherence and usage compared to APAP, while reducing clinical resource burden. Additionally, there is some evidence to suggest that adherence gap between may widen over time. Ultimately, cMAP® represents a significant step toward addressing one of the biggest challenges in sleep medicine and drive meaningful, long-term health outcomes for OSA patients. This abstract is funded by: NRC IRAP, ACOA, NovaResp Technologies Inc

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