This presentation is designed for medical professionals struggling to work with the everyday challenges of cpap or bi-level patients.

1. Managing your patients for
tonight and the long-term

3.  Your image and perception
◦ Instilled trust
 Actions speak a thousand words
 Use props, posters and materials
 Understand your influence
 Features of today‟s PAP
◦ Know what your doc prescribes
 Sleep hygiene and gimmicks

4.  Instructing behavior to affect your patients
 Few consistencies in research
◦ Patients feel “closed in”
◦ Disease, age, pressure unrelated
 Using theory and your experience
◦ Develop consistent strategy
 Practice your interactions
◦ Most patients have similar concerns
 Make yourself available

5.  Key concepts and Principles
◦ Develop Discrepancy
 Help patient understand their choices with
PAP and risks without
◦ Express Empathy
 Avoid being pulled into a debate about PAP
◦ Expect Resistance
 Ever meet a happy PSG or titration patient?
◦ Support
 “Most people take a while to adjust to CPAP
and to build the use of it into their daily
lives”

6.  Consequences of OSA are real
◦ Daytime sleepiness
◦ Mood changes
◦ Depression
◦ Irritability
◦ Impairment in attention, concentration &
memory
 Effective Therapy time is…
◦ 4.5 Hours
 Despite it‟s efficacy, 25% of patients
discontinue use during the first year.

7. Conclusion:
 “Self confidence appeared to be the
strongest single psychological
predictor of long-term adherence.
Behavior change constructs are
among the strongest predictors of
PAP adherence in the literature to
date.”
◦ Brief behavioral Therapies reduce Early
PAP Discontinuation Rates in SAS:
Preliminary findings

8.  Manufacturers CEU
 Monographs
 Professional Societies
 Trade Journals
 Networking events
 Home Testing

9.  We asked a few of our veteran clinicians
about what they‟d like to convey to patients
at their PSG and titration studies. It‟s
interesting what we found.
What do you think
they said?

10. Educate their patients more
on the reasons they‟re
using PAP.

11.  Do you know much about sleep apnea?
 Are you nervous?
 When was your last good night of sleep?
 What are you doing tomorrow?

12.  Explain in layman‟s terms.
◦ Often, the side effects of apnea affect patient
understanding
 Patients need patience
◦ PAP has a period of adjustment
 Focus on reality
◦ Explain the mechanics of an air splint
◦ Educate on why PAP works and co-morbidities
 Empathize
 Encourage contact with home care company
“Imagine if you had never worn a pair of shoes. With your first
pair, you gradually get used to them but they can cause pain and
blisters. However, you can‟t just fix it by changing the pair of shoes
continuously."

13.  “I hear the word „suffocated‟ a lot”
◦ Exhaling and mechanics of the PAP
 Practice during the day
◦ 30 minute increments
◦ With mask, with PAP
 Educate on variable adjustment period
◦ Time frames with CMS patients
 „Walk‟ patient through prior to titration
◦ What will happen
 Humidity
◦ Comfort
◦ Season

14.  Often receive therapy quicker
 More benefit
 Tolerance for medical care
 Do you agree?

15. Moral to every story

17.  Difficult problems can be solved when
everyone works together
◦ Key Virtues
 Cooperation
 Hard work
 Persistence
 Helpfulness
 Self confidence
 Compassion