Relationship Between Hours of CPAP Use and Achieving Normal Levels of Sleepiness and Daily Functioning

Terri E. Weaver, Greg Maislin, David F. Dinges, Thomas Bloxham, Charles F. P. George, Harly Greenberg, Gihan Kader, Mark Mahowald, Joel Younger, and Allan I. Pack

Study Objectives

Evidence suggests that, to maintain treatment effects, nasal continuous positive airway pressure () therapy for obstructive sleep apnea (OSA) needs to be used every night. What remains unknown is the nightly duration of use required to normalize functioning. This study, employing probit analyses and piecewise regression to estimate doseresponse functions, estimated likelihoods of return to normal levels of sleepiness and daily functioning relative to nightly duration of .

Measurement and Results

Before treatment and again after 3 months of therapy, participants completed a day of testing that included measures of objective and subjective daytime sleepiness and functional status. There were significant differences in mean nightly CPAP duration between treatment responders and nonresponders across outcomes. Thresholds above which further improvements were less likely relative to nightly duration of CPAP were identified for Epworth Sleepiness Scale score (4 hours), Multiple Sleep Latency Test (6 hours), and Functional Outcomes associated with Sleepiness Questionnaire (7.5 hours). A linear dose-response relationship (P < 0.01) between increased use and achieving normal levels was shown for objective and subjective daytime sleepiness, but only up to 7 hours use for functional status.


Our analyses suggest that a greater percentage of patients will achieve normal functioning with longer nightly CPAP durations, but what constitutes adequate use varies between different outcomes.

Full text

Sleep. 2007 June 1; 30(6): 711–719.

Randy Clare

Randy Clare

Randy Clare brings to The Sleep and Respiratory Scholar more than 25 years of extensive knowledge and experience in the sleep and pulmonary function field. He has held numerous management positions throughout his career and has demonstrated a unique view of the alternate care diagnostic and therapy model. He is considered by many an expert in the use of a Sleep Bruxism Monitor in a dental office. Mr. Clare's extensive sleep industry experience assists Sleepandrespiratoryscholar in providing current, relevant, data-proven information on sleep diagnostics and sleep therapies that are effective for the treatment of sleep disorders. Mr Clare is a senior brand manager for Glidewell Dental Laboratory his focus is on dental treatment for sleep disordered breathing.

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