Individualizing Care for Patients With Sleep Apnea

The ongoing treatment of patients with sleep apnea often depends on available resources and patient needs. While some patients can be effectively treated by primary care providers, a significant portion—possibly up to half—benefit from comanagement with sleep specialists. Regular follow-ups every few months can help monitor therapy adherence and address complications. However, with thousands of patients on continuous positive airway pressure (CPAP) devices, it’s not always feasible for sleep medicine specialists to follow every case closely. The emphasis is on early intervention to establish healthy habits and ensure the effective use of therapy during the critical initial period.

The first 90 days of CPAP therapy are especially important, as compliance requirements set by insurers such as Medicare mandate consistent use for continued coverage. During this time, patients often need intensive support to build a routine and overcome early challenges. If the standard therapy is not tolerated or effective, alternative strategies should be considered. Collaboration with other specialties such as bariatric surgery; ear, nose, and throat; and weight management are valuable, as improving overall health can positively influence sleep apnea outcomes. Even if CPAP is not successful, other interventions aimed at weight loss or airway management can provide meaningful benefits.

When patients struggle to tolerate CPAP despite multiple attempts with different masks or settings, exploring other options becomes necessary. Advances in weight loss medications, particularly incretin-based therapies, have shown promising effects on obstructive sleep apnea and can be part of a broader treatment plan. Overall, a multidisciplinary approach tailored to each patient’s unique situation is crucial. Supporting patients early and offering alternative therapies when needed can lead to better health outcomes and improved quality of life. The discussion reflects a hopeful outlook on ongoing innovations and partnerships that enhance care for those with sleep apnea.