People with obstructive sleep apnea can gain health benefits from using their CPAP machine as little as two hours per night, according to a study led by ResMed and presented at the American Thoracic Society’s annual International Conference.

The retrospective, observational study analyzed the deidentified usage data of 180,000 US positive airway pressure (PAP) users to observe their average rates of all-cause hospitalization and emergency room visits based on the number of nightly hours they use PAP, from zero to nine. Researchers found:

  • The minimum CPAP usage threshold for benefit was 2-3 hours per night (up to 50% lower than the 4 hours required by the US Centers for Medicare and Medicaid and many private payers to prove adherence)
  • Benefits begin at 2 hours of nightly CPAP use and increase each hour up to 7 hours per night. Benefits were seen at 90 days, one year, and two years into the study.
  • Over the two years, each additional hour of nightly CPAP use reduced:

“This study can positively change how healthcare professionals prescribe and encourage sleep apnea sufferers to use PAP—and how they’re covered,” says Atul Malhotra, lead author and research chief of pulmonary, critical care, and sleep medicine at the University of California San Diego, in a release.

The US Centers for Medicare and Medicaid define CPAP therapy adherence as using a PAP device for at least four hours per night for 70% of nights in a consecutive 30-day period in the first 90 days of therapy. Patients who do not achieve adherence may risk losing their machine after 90 days or having to pay for it themselves, depending on their insurance coverage.

“If just two hours of nightly PAP use can significantly lower a patient’s risk of getting hospitalized, our health systems should encourage and enable people to access and keep using these solutions,” Malhotra says.