{
  "abstract": "Introduction During a research trial there are lessons to be learnt beyond the main study objectives. Two case studies are presented following investigation of adverse events reported during the PAPMAT trial, which investigates the use of Mandibular Advancement Device (MAD) combined with CPAP to improve compliance with CPAP therapy.Method Retrospective case studies.Results Two patients experienced adverse events, not related to the research study procedures, requiring emergency admissions to local hospitals. Both had moderate to severe OSA and were receiving CPAP therapy prior to their admissions. Neither used CPAP during their admissions. Both had emergency surgical procedures during their admissions.Discussion These are two examples of patients whose regular CPAP therapy was omitted during emergency hospital admission. Our experience from managing a large population of patients on long-term CPAP is that these are not isolated occurrences. The reasons why CPAP therapy is omitted are often unclear. While some cases may represent active clinical decision making, in other cases CPAP omission may simply represent oversight by the patient and/or clinical team. Anaesthetic guidelines increasingly support pre-operative screening for OSA and pre-emptive treatment if appropriate. The benefits of this are unclear as evidence is lacking. However, unless there are reasonable grounds for suspending CPAP therapy during intercurrent illness or elective clinical episodes, in the absence of evidence to the contrary a sensible approach would be to continue CPAP.Conclusions It is important when introducing patients to CPAP to ensure that education includes the benefits of avoiding unnecessary interruptions to therapy. Wider clinical awareness of holistic benefits of CPAP therapy for people with OSA would also be useful.",
  "authors": [
    {
      "affiliations": [
        "University of Birmingham, Birmingham, UK"
      ],
      "name": "Sue Cross"
    },
    {
      "affiliations": [
        "Royal Papworth Hospital, Cambridge, UK"
      ],
      "name": "Jacqueline Archer"
    },
    {
      "affiliations": [
        "Royal Papworth Hospital, Cambridge, UK"
      ],
      "name": "Earl Palas"
    },
    {
      "affiliations": [
        "Royal Papworth Hospital, Cambridge, UK"
      ],
      "name": "Karin Tahir"
    },
    {
      "affiliations": [
        "Royal Papworth Hospital, Cambridge, UK"
      ],
      "name": "Timothy Quinnell"
    }
  ],
  "title": "P65 Inpatient use of CPAP for OSA",
  "uid": "bb583b91-4fc5-5007-83df-e735daa1e6d8"
}