williaty

williaty t1_jc8qhup wrote

As a fellow CPAP user that's really dug into the details on therapy, my instant suspicion is this: How well controlled are they looking at for "on CPAP therapy"? The clinical threshold for successful therapy is an AHI of 5 or below. However, there's LOTS of patient reports saying that getting from untreated down to an AHI of 5 didn't actually make them feel better. It's pretty common to see patient reports of symptom improvements in the AHI 1-2 range. So if the study is considering people treated/compliant/on therapy at AHI <=5 but the physiologically significant threshold is AHI <=1.5 or something, that's a LOT of people who are "treated" but not actually going to have better outcomes.

Additionally, it's sadly common for patients to start therapy successfully, both in the clinical sense of AHI<5 but also in terms of feeling better but then slowly drift out of the desired range as they gain weight, age, or have other life changes. Again, this could be producing a large cohort that's being counted as treated in the study but isn't getting the health benefits.

But yeah, this worries me too and I'd like to see more detailed investigation.

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