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Blog Feature

By: Zack Freeman on March 7th, 2016

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How to Work Hard at PAP Adherence

Sleep Disorders | Sleep Medicine

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Advice from a sleep technologist on how to increase PAP adherence rates

An argument could be made that a successful PAP adherence rate for a sleep disorders facility is achieved by repetitive small successes with each patent, that are accomplished with much work on the part of the referring and treating providers as well as the clinical and support staff.

Let us make a general list of these successes:

  • Success in recognizing the risk of a sleep apnea…
  • Successfully assessing the patient for sleep apnea or other sleep disorders…
  • Success in obtaining a quality polysomnogram or home sleep apnea test…
  • Successfully educating the patient of the results and what they mean…
  • Successfully introducing the patient to therapy…
  • Successful mask fit…
  • Successful manual or auto titration…
  • Successful follow-up to address issues and continue education…
  • Successfully tracking the patient’s progress…

This list of necessary successes translates into a list of tasks that need to be completed throughout the process of diagnosing and treating a sleep apnea patient. The role of the sleep technologist during this process varies, but is copious and important. What is the result? National averages for CPAP adherence vary. What must the patient be able to do to be considered adherent to therapy, and why aren’t they?

 Let us revisit our list, but let us revise it to describe the role of the patient this time:

  • Communicate symptoms and risks of a sleep apnea to the physician…
  • Make the appointment to be assessed for sleep apnea or other sleep disorders…
  • Undergo the polysomnogram or home sleep apnea test…
  • Understand and remember the results of the test and what they mean…
  • Retain the information provided regarding the purpose and benefit of therapy…
  • Learn about, try on and choose an interface…
  • Proceed with treatment…
  • Return for follow up visit, articulate problems and discuss progress… 

We may think that the patient’s role is to just “sit back, follow directions and enjoy the ride”, but in fact there’s a lot of work the patient must do…and this may be just one of several significant life events going on in the person’s life!

So now that we’ve looked at the roles the technologist and patient have in achieving PAP adherence, what can we do to ensure successes in each these tasks? Let’s start with a simple principle: "The price of success is hard work, dedication to the job at hand, and the determination that whether we win or lose, we have applied the best of ourselves to the task at hand."- Vince Lombardi, American football player, coach, and executive.

How do we apply this principle to each task on our list? When we explain procedures to our patient, do we do the bare minimum necessary to get cooperation, or do we take a moment to apply patient communication and education strategies? Do we relay the general idea and let the details escape, or are we prepared to go into as much detail as the patient needs, with confidence? Do we understand the process the patient goes through, can we prepare him for the next step?

No matter who the role of the educator falls to within the sleep center, as technologists we should always remember there is work ahead and do our best to do OUR part to help our patients do THEIR part.

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