Saturday , October 21 2017
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Asking the Question: “Are You Wearing Your CPAP?”

A male patient, 56 years of age, with type 2 diabetes, hypertension, congestive heart failure, and sleep apnea visited. We hadn’t seen him for 6 months. His blood pressure was up, in the 140-160/90–102 range, glucose levels were higher than his targets, he was gaining weight, and continually complaining of his exhaustion. He was eating healthy, active, taking his meds as prescribed. He just couldn’t figure it out. We asked,  “Are you wearing your CPAP?”…

He said, “No, I moved and never unpacked that box.”

Before making any medication changes, we encouraged him to resume wearing his CPAP at night, and monitor. We set him up for remote patient monitoring, and saw his blood pressure and glucose come down to his targets. His weight also slowly started to drop. I spoke with him a week later. He said after one night on CPAP he felt his energy get better and he thanked me.

Lessons Learned:

  • Assess your patients’ sleep habits.
  • Respect sleep apnea as an underlying cause of increased blood pressure, glucose, weight, and more.
  • Screen for sleep apnea, and refer to sleep labs/sleep specialists if you suspect a sleep issue.
  • If you know your patient has sleep apnea, ask the simple question, “Are you wearing your CPAP?”
  • If your patient is not wearing his or her CPAP, ask why. Sometimes the answer is simple, and a simple solution can turn things around. Sometimes it is because it is uncomfortable. If uncomfortable, encourage your patient to contact their sleep medicine team to help recommend a device that is more comfortable.
  • Follow up with your patients to make sure they use the recommended treatment. If they aren’t using the recommended treatment, find out why, and help problem solve.

Anonymous

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