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Sawyer AM, Wallace DM, Buenaver LF, Watach AJ, Blase A, Saconi B, Patel SR, Kuna ST, Punjabi NM. Where to Next for Optimizing Adherence in Large-Scale Trials of Continuous Positive Airway Pressure? Sleep medicine clinics. 2021 Mar 1; 16(1):125-144.
Large-scale randomized trials of positive airway pressure (PAP) efficacy have been largely negative but PAP adherence was notably suboptimal across the trials. To address this limitation, evidence-based PAP adherence protocols embedded within the larger trial protocol are recommended. The complexity of such protocols depends on adequacy of resources, including funding and inclusion of behavioral scientist experts on the scientific team, and trial-specific considerations (eg, target population) and methods. Recommendations for optimizing PAP adherence in large-scale trials are set forth that address rigor and reproducibility.