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Older man wearing a PAP mask


What is adherence and why does it matter to me, the patient?

Adherence or compliance is how often PAP (Positive Airway Pressure) is used, both the number of days and the number of hours. The minimal goal for adherence is to wear it at least 4 hours per night for 70% of the time which is 5 out of 7 nights per week.  As a patient, adherence is important for overall success with the therapy.  PAP can greatly improve the quality of sleep, not just the quantity or length of time spent sleeping. 


Why does my doctor want to know how I’m doing with PAP (Positive Airway Pressure)?

Your doctor wants to know how things are going with your therapy in order to check that it is working well and beneficial to your health. A typical adherence or compliance report contains:
  • Percentage of use by days per month (Example: 27 days out of 30 or 90%)
  • Percentage of use over 4 hours per night (Example: 15 days out of 30 or 50%)
  • Average hours when therapy is used (Example: 5 hrs. 23 minutes)
  • Leak rates
  • AHI (Apnea Hypopnea Index)-the number of respiratory events (apnea) that occur on average

If there are any values that seem to be outside of normal range then a change may be necessary to improve the PAP therapy by increasing or decreasing the pressure(s), suggesting a mask change, or encourage greater PAP use in general.

If adherence or compliance is poor or remains intolerable despite adjustments, then alternative treatments or therapies may be explored.

Reviewing adherence data is very important for the physician in determining the course of your treatment for sleep apnea and overall sleep health.

How can I improve my adherence with PAP (Positive Airway Pressure)?

Adjusting to wearing a mask is not easy for some patients. Sometimes there are barriers or things that prevent people from using their therapy. Maybe the mask doesn’t fit well or maybe your nose ends up dry.  Maybe you travel for work and keep forgetting to pack your equipment. Maybe you just aren’t motivated to put it on after a long day.  All of these are common for many, many people.

Easy Tip & Reminders

  • Create a routine that includes using your machine nightly, especially in the early days when you first start therapy.
  • If your mask is the main issue and not the pressure, contact your home care company and see if you can try another mask that may work better for you
  • If you frequently fall asleep before you put it on, set an alarm beforehand to wake you so you can put it on for the remainder of the night.
If you have difficulties making it to the 4 hours for wearing it, try increasing the time in small increments throughout the week rather than all at once.
  • Increase usage by 15 minutes at a time, by the end of 7 days your overall usage can improve by 30 minutes or more

If the pressure is the issue call your home care company to check settings that can help you adjust easier to the pressure(s).

Contact the PAP Sleep Coach