Although recent work by Boyd suggests the AHI returns rapidly during off-PAP sleep for many patients, prior work on CPAP withdrawal shows that a subset (maybe half!) have a delayed return of their OSA.
Think about the patient with every other night use - if they are in this phenotype (delayed return), maybe their off-nights are "OK" biologically. BUT, such a patient will be considered a treatment failure by insurance (4h, 70% rule), and most clinical trials using the same or similar criteria. This prior data argues that the ever-present barrier of higher and higher adherence might not be a battle all patients must endure?
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