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Respiratory/Sleep

Exposure Therapy is Latest Wrinkle in Battle for CPAP Compliance

November 4, 2013

ST. LOUIS – An effort to desensitize patients to CPAP masks may ease the transition for patients and ultimately boost compliance. The small-sample “exposure therapy” pilot study concluded that patients were able to significantly increase the number of minutes per night on CPAP after the desensitization program.

As reported in MedPage Today (originally at the CHEST Meeting in St. Louis), some patients who had been unable to tolerate the treatment, mostly because of an inability to wear the mask properly, were able to significantly increase the number of minutes per night on CPAP.

Reporter Kristina Fiore reports that Patricia Dettenmeier, MSN, of Saint Louis University, and colleagues, deemed CPAP desensitization a “potential therapy for patients with obstructive sleep apnea and claustrophobia or mask intolerance even after several years of non-use or inadequate use.”

Dettenmeier and colleagues tested an exposure-therapy protocol in 22 patients who had problems with CPAP compliance. The protocol, which was implemented by a nurse practitioner, involved several techniques for getting patients used to the mask.

According to Fiore, patients were instructed to wear the mask while awake for an hour each day with the mask attached to the CPAP device and the device switched on in order to practice breathing through the mask. Patients could do this while watching television, reading, or doing some other sedentary activity, Dettenmeier said.

Within a month of starting the exposure therapy, Dettenmeier reported, 10 patients were able to use CPAP and seven were fully adherent. Those who were adherent spent significantly more minutes using the treatment than those who were not adherent (339.5 min versus 47.22 min, P<0.001).