The OSA Alliance sent an email survey on CPAP allocation issues to all UK Sleep Centres listed on the SATA database end January-early February 2022. Replies came from 22 UK centres, including NI, Scotland, Wales.
91% of respondents confirmed a current supply shortage of CPAP machines: receiving on average around half their usual delivery with some erratic delivery. Whilst 41% of sites had CPAP originally supplied by Phillips, whose Field Safety Notice affected supplies, the other sites with current CPAP delays were all originally supplied by ResMed. Seven centres have changed suppliers to improve supply or are getting available machines from more than one supplier, so teams are using less familiar CPAP models. Humidifier supply was an issue for some, with concerns about impact on CPAP adherence.
Waiting list size for CPAP varies between UK centres from 0-400 patients, with 5-50 patients being added per week. All centres with CPAP shortages are using the prioritisation criteria set out by the BTS. Whilst patients with the highest priority requiring urgent CPAP can start this quickly in all centres, the average wait time to start routine CPAP is 13 weeks (range 2 to 40 weeks). The majority of centres said the CPAP delays were not due to local staff shortages, but due to CPAP supply issues.
Most sleep centres reported delays in the routine replacement of older CPAP machines if they undertake this, but all said replacement occurred if the machine stopped working properly. Clearly replacement impacts the number of CPAP machines available for new patients. Most centres are actively trying to find patients not using their CPAP to have the machines returned in order to reuse them.
Looking at alternative therapy recommended by NICE to CPAP, only 45% of centres have access to titratable mandibular splints via dental colleagues for people with mild to moderate OSA.
Demand for sleep services continues to grow, and the CPAP supply issue is the latest challenge in an often under-resourced area.
Sophie West, Annabel Nickol, Gillian Gibbons
OSA Alliance – facilitating collaboration between experts across patient and professional sleep organisations focusing on OSA, including BTS, BSS, ARTP and SATA