• Heidi Avellan-Hietanen, Paula Maasilta, and Adel Bachour.
• Sleep Unit, Heart and Lung Centre, Helsinki University Hospital, University of Helsinki, Helsinki, Finland. heidi.avellan-hietanen@hus.fi.
• Respir Care. 2020 Oct 1; 65 (10): 1541-1546.

BackgroundAbout one third of patients fail their first CPAP trial due to several factors. Despite its clinical importance, data on the success of CPAP re-initiation are scarce.MethodsOf the 6,231 patients referred to our sleep unit for sleep apnea, we included 224 subjects referred for re-initiation of CPAP therapy (re-CPAP). The control group consisted of 228 CPAP-naïve subjects referred for CPAP initiation. Data on subject characteristics, sleep study, and CPAP outcome were collected.ResultsThe re-CPAP group had more severe apnea than the control group. After at least 1 y of CPAP therapy, 52% of the re-CPAP group stayed on therapy; this was significantly lower than the 67% adherence for the control group (P = .001). No gender difference was observed in the control group (P = .12), whereas women in the re-CPAP group remained on therapy significantly less than men (P = .002).ConclusionsThe percentage of subjects who stayed on CPAP therapy after 1 y was significantly reduced when CPAP was re-initiated compared to the control group. CPAP acceptance after re-initiation was higher among men than women. Further studies are necessary to explain this gender difference.Copyright © 2020 by Daedalus Enterprises.

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