{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:38:00Z","timestamp":1787017080347,"version":"build-2736575974"},"reference-count":9,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/100017647","name":"ResMed","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017647","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2018,12,20]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>For patients with obstructive sleep apnoea (OSA) who are initially non-compliant with continuous (automatic) positive airway pressure (CPAP\/APAP) therapy, a bilevel PAP (Spont\/VAuto) therapy transition pathway is available to improve therapy adherence. The aim of this retrospective study was to compare PAP therapy usage data of patients with non-compliant OSA (ncOSA) on CPAP\/APAP who were switched to bilevel PAP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A PAP telemonitoring database was queried between 1 January 2015 and 31 July 2016 for eligible patients started on CPAP\/APAP and non-CMS (United States Center for Medicare and Medicaid Services) compliant and switched to bilevel PAP within 90 days of starting CPAP\/APAP therapy. PAP therapy data on all patients were compared before switch (CPAP\/APAP) and after switch (VAuto\/Spont).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 1496 patients with ncOSA identified, 30.3% used CPAP, 62.3% APAP, and 7.4% both APAP and CPAP before switching to a bilevel mode. 47.8% patients switched to Spont mode and 52.2% to VAuto mode. PAP usage significantly improved by 0.9 h\/day (p&lt;0.001) and all other device metrics (residual apnoea\u2013hypopnoea index and unintentional mask leak) also improved after the switch. No patients had achieved US CMS criteria for compliance before the switch, and 56.8% did after.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This shows for the first time that there may be potential benefit from switching from CPAP\/APAP to bilevel PAP for patients struggling with PAP adherence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjresp-2018-000380","type":"journal-article","created":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T06:09:28Z","timestamp":1556604568000},"page":"e000380","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Compliance after switching from CPAP to bilevel for patients with non-compliant OSA: big data analysis"],"prefix":"10.1136","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4716-2827","authenticated-orcid":false,"given":"Adam V","family":"Benjafield","sequence":"first","affiliation":[{"name":"ResMed Science Center, San Diego, California, USA"},{"name":"medXcloud Group, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Louis D","family":"Pepin","sequence":"additional","affiliation":[{"name":"medXcloud Group, San Diego, California, USA"},{"name":"HP2 Laboratory, INSERM U1042, Universit\u00e9 Grenoble Alpes, Grenoble, France"},{"name":"EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Valentine","sequence":"additional","affiliation":[{"name":"ResMed Science Center, San Diego, California, USA"},{"name":"medXcloud Group, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A","family":"Cistulli","sequence":"additional","affiliation":[{"name":"medXcloud Group, San Diego, California, USA"},{"name":"Charles Perkins Centre, School of Medicine, University of Sydney and Royal North Shore Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6588-5039","authenticated-orcid":false,"given":"Holger","family":"Woehrle","sequence":"additional","affiliation":[{"name":"medXcloud Group, San Diego, California, USA"},{"name":"Sleep and Ventilation Center Blaubeuren, Lung Center Ulm, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos M","family":"Nunez","sequence":"additional","affiliation":[{"name":"ResMed Science Center, San Diego, California, USA"},{"name":"medXcloud Group, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Armitstead","sequence":"additional","affiliation":[{"name":"medXcloud Group, San Diego, California, USA"},{"name":"ResMed Science Center, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Malhotra","sequence":"additional","affiliation":[{"name":"medXcloud Group, San Diego, California, USA"},{"name":"University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,4,29]]},"reference":[{"key":"2025083110564445000_6.1.e000380.1","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1164\/rccm.201202-0200OC","article-title":"Continuous positive airway pressure treatment of sleepy patients with milder obstructive sleep apnea: results of the CPAP apnea trial North American program (CATNAP) randomized clinical trial","volume":"86","author":"Weaver","year":"2012","journal-title":"Am J Respir Crit Care 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obstructive sleep apnea not responsive to or intolerant of continuous positive airway pressure ventilation","volume":"11","author":"Carlucci","year":"2015","journal-title":"J Clin Sleep Med"},{"key":"2025083110564445000_6.1.e000380.6","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1093\/sleep\/26.7.864","article-title":"A randomized, double-blind clinical trial comparing continuous positive airway pressure with a novel bilevel pressure system for treatment of obstructive sleep apnea syndrome","volume":"26","author":"Gay","year":"2003","journal-title":"Sleep"},{"key":"2025083110564445000_6.1.e000380.7","doi-asserted-by":"crossref","first-page":"43","DOI":"10.5664\/jcsm.1658","article-title":"A pilot study assessing adherence to auto-bilevel following a poor initial encounter with CPAP","volume":"8","author":"Powell","year":"2012","journal-title":"J Clin Sleep Med"},{"key":"2025083110564445000_6.1.e000380.8","first-page":"CD003531","article-title":"Pressure modification for improving usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea","volume":"4","author":"Smith","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"2025083110564445000_6.1.e000380.9","doi-asserted-by":"crossref","first-page":"479","DOI":"10.5664\/jcsm.6506","article-title":"Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline","volume":"13","author":"Kapur","year":"2017","journal-title":"J Clin Sleep Med"}],"container-title":["BMJ Open Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjresp-2018-000380","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T17:56:54Z","timestamp":1756663014000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopenrespres.bmj.com\/lookup\/doi\/10.1136\/bmjresp-2018-000380"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,4,29]]},"published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1136\/bmjresp-2018-000380"],"URL":"https:\/\/doi.org\/10.1136\/bmjresp-2018-000380","relation":{},"ISSN":["2052-4439"],"issn-type":[{"value":"2052-4439","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]}}}