CPAP Adherence Rose for Many After 90 Days

A study showed that some patients who struggle with early CPAP use may still reach long-term goals.

Updated on Sept. 18, 2026 in Asthma

Gouache-painted illustration of a nasal sleep mask on a pillow, representing the persistence of long-term health treatment. — A study of over 130,000 California adults found that many patients who initially struggle with CPAP usage improve their nightly adherence after 90 days. AI Illustration. Upload story photo >

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Should insurance coverage rules for medical devices provide more flexibility for patients adjusting to new treatment?

Researchers presented data in May 2026 showing that many patients who failed to meet CPAP adherence benchmarks at 90 days improved their usage by the one-year mark. This finding, based on a cohort of 132,492 California adults, suggests that early struggles may not predict permanent device abandonment.

Why it matters

Current Centers for Medicare & Medicaid Services policy requires strict adherence by day 90 to maintain coverage, potentially penalizing patients who need more time to adjust. Understanding that usage often increases after this window could inform future discussions about coverage and support for patients.

This retrospective study of 132,492 adults followed CPAP usage over eight years, finding that 14% of those missing early targets reached the 4-hour benchmark by one year. The results suggest that initial adherence metrics may not fully capture patient progress.

The players

Kaiser Permanente Southern California

A healthcare provider that offers CPAP access and support, which served as the clinical setting for this retrospective study.

Centers for Medicare & Medicaid Services

The federal agency that mandates 90-day CPAP adherence benchmarks as a requirement for ongoing medical equipment coverage.

The details

CPAP usage often requires time-intensive adjustments to mask fit and pressure settings, known as titration, to improve comfort. When patients receive ongoing support without strict coverage cutoffs, they may overcome early barriers to reach consistent nightly use. The study highlighted that younger patients, women, non-White groups, and those with lower socioeconomic status are more likely to experience early nonadherence.

The study cohort of 132,492 adults received CPAP devices between 2015 and 2023.
Study results were presented at the ATS 2026 conference in May 2026.

Health Landscape

The study findings challenge the arbitrary 90-day cutoff set by the Centers for Medicare & Medicaid Services CPAP adherence policy, suggesting that patients often improve their usage habits well after that initial window. This shifts the focus from early metrics toward more flexible, long-term support for sleep apnea management.

If you are struggling to use your CPAP device consistently, it is worth discussing the difficulties with your doctor to see if mask fit or pressure adjustments can help. Do not assume that failing to meet early usage targets means you have no path toward successful, long-term treatment.

The takeaway

Early struggles with CPAP devices are common and often resolve with time and proper titration support. If you find your device uncomfortable, contact your healthcare team to request a mask refitting or pressure assessment instead of discontinuing use.