HUS has eliminated waiting list for sleep apnea treatment

The waiting lists for sleep apnea patients have been reduced to zero through an effective digital care pathway and group and remote initiation of CPAP (continuous positive airway pressure) therapy. The methods vary by hospital and treatment location.

In 2025, a digital sleep apnea care pathway for the entire HUS region will be made available in Finnish, Swedish and English. It will further help the situation. Faster initiation of treatment benefits the patients first and foremost.

Other causes of fatigue than sleep apnea

The number of sleep apnea patients has been increasing steadily in recent years. Annually, HUS receives 2,500 referrals for sleep apnea patients from Helsinki alone.

Most of these patients will remain permanently in CPAP therapy, and patients whose occupation requires it are monitored at HUS.

In 2023, a joint clinical pathway for sleep apnea in the HUS region was updated and the division of labor between primary healthcare and HUS was established.

“There are dozens of causes for fatigue. CPAP therapy started at HUS treats sleep apnea and improves its symptoms, but if there is some other cause behind the symptoms, then ending up in the ‘sleep apnea pipeline’ can delay its treatment,“ says Senior Ward Physician Tiina Mattila from Meilahti Triangle Hospital.

More than 30 percent do not use their CPAP machine

Patients in Helsinki alone have around 18,000 CPAP machines on loan from HUS. The machine helps keep the airways open and reduces lapses in breathing during sleep.

Studies have shown that people of working age, those who are significantly overweight and those with severe sleep apnea benefit most from CPAP. Severe sleep apnea increases the risk of cardiovascular diseases.

For the therapy to be useful, the patient should wear the CPAP machine for at least 60–70 percent of the time and a minimum of 4 hours per night. However, not everyone commits to long-term CPAP therapy and the machine sits unused. Discontinuations of CPAP use occur daily at HUS.

HUS can monitor CPAP usage hours remotely. About 20 to 30 percent of the machines are practically abandoned.

This means that people have millions of euros’ worth of unused CPAP machines in their homes. The problem is nationwide. From a healthcare cost perspective, the patients should either start using the machines again or return them to the hospitals so that they can be redistributed.

In case of problems with the machine, the digital care pathway and sleep apnea nurses offer guidance. If the machine remains unused despite additional guidance, adjustments to settings, and refitting the mask, the machine should be returned. Not everyone does this, however.

"Some feel that the difficulty of using the CPAP machine outweighs its benefit. That is why we hope that the digital care pathway will provide additional information and support to help our patients succeed in their treatment,” says Paula Kauppi, Head of Pulmonary Diseases from HUS Heart and Lung Center.