From the Guidelines
Retesting for sleep apnea in CPAP users is not routinely recommended, but rather based on individual patient circumstances, such as significant changes in symptoms or health status, as stated in the American Academy of Sleep Medicine clinical practice guideline 1. When considering retesting, several factors come into play, including:
- Significant weight changes (gain or loss of 10% or more of body weight)
- Development of new medical conditions that might affect breathing
- Undergoing treatments that could impact sleep apnea
- Recurring symptoms despite CPAP use
- Considering discontinuing CPAP therapy or changing to an alternative treatment The American Academy of Sleep Medicine recommends that patients with a previously established diagnosis of OSA who are currently on PAP therapy and have good symptom control should continue PAP therapy, even when prior testing results are not readily available 1. Yearly evaluation by a trained health care provider is reasonable, although longer periods of follow-up may be appropriate for selected patients who are highly adherent to PAP therapy, have sustained resolution of OSA-related symptoms, and have no concerns regarding their PAP therapy 1. In contrast, patients with persistent or recurrent sleep-related complaints or persistent difficulties with PAP use should receive more frequent follow-up to address their issues 1. Regular follow-ups with a sleep specialist are crucial to monitor therapy effectiveness and address any issues with the CPAP device or mask, as sleep apnea severity can change over time due to factors like aging, weight fluctuations, and changes in overall health.
From the Research
Retesting for Sleep Apnea in CPAP Users
There is limited information available on when to retest for sleep apnea in those using CPAP. However, some studies provide insights into the effectiveness of CPAP and alternative treatments:
- CPAP is considered the gold standard of treatment for obstructive sleep apnea (OSA), but adherence can be a challenge for some patients 2, 3.
- Oral appliance therapy (OAT) is a potential alternative for patients who struggle with CPAP, and it has been shown to be effective in reducing the severity of OSA, although to a lesser extent than CPAP 4, 5.
- Combination therapy with CPAP and OAT may be beneficial for patients who have an incomplete response to OAT alone or who cannot tolerate high CPAP levels 6.
- The decision to retest for sleep apnea in CPAP users may depend on various factors, such as changes in symptoms, weight, or treatment adherence, but there is no clear guidance on the optimal timing for retesting.
Factors to Consider
Some factors to consider when deciding whether to retest for sleep apnea in CPAP users include:
- Changes in symptoms, such as increased daytime sleepiness or snoring 3.
- Changes in weight or body mass index (BMI), which can affect the severity of OSA 2.
- Adherence to CPAP treatment, which can impact the effectiveness of therapy 4, 5.
- The presence of other health conditions, such as cardiovascular disease or diabetes, which can be affected by OSA 5.