Positive airway pressure (PAP) is the most effective therapy for obstructive sleep apnoea (OSA), a condition affecting an estimated 936 million adults worldwide [1]. Adequate PAP adherence has been defined as 4 h of average use in most research studies. Many US insurance carriers and national payers, including the Centers for Medicaid and Medicare Services (CMS), determine coverage of PAP and supplies based on this metric. If Medicare patients do not meet the threshold of 4 h per night for 70% of nights, their PAP may be confiscated in the USA [2]. This policy may have detrimental consequences for Medicare beneficiaries with OSA [3]. In France, however, a 3-h average use is required for PAP coverage, established more than 20 years ago as a legal minimal usage not corresponding to any physiological threshold. Suboptimal CPAP use, less than 4 h per night, may still have beneficial effects on daytime sleepiness. Removing CPAP in those who routinely use it for 2–3 h a night worsened their daytime sleepiness. http://bit.ly/36FjnF6

中文翻译：

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CPAP 依从性不佳：半条面包总比没有面包好

气道正压通气 (PAP) 是阻塞性睡眠呼吸暂停 (OSA) 的最有效疗法，OSA 是一种影响全球约 9.36 亿成年人的疾病 [1]。在大多数研究中，足够的 PAP 依从性被定义为平均使用 4 小时。许多美国保险公司和国家付款人，包括医疗补助和医疗保险服务中心 (CMS)，根据此指标确定 PAP 和用品的覆盖范围。如果 Medicare 患者 70% 的夜晚没有达到每晚 4 小时的阈值，他们的 PAP 可能会在美国被没收 [2]。该政策可能会对患有 OSA 的 Medicare 受益人产生不利影响 [3]。然而，在法国，PAP 覆盖需要 3 小时的平均使用时间，这是 20 多年前建立的法定最低使用量，不符合任何生理阈值。次优 CPAP 使用，每晚少于 4 小时，仍可能对白天的困倦有有益的影响。那些经常使用 2-3 公顷夜晚的人去除 CPAP 会加重他们白天的困倦。http://bit.ly/36FjnF6