What is the true prevalence of CPAP-related GI side effects in the UK?

<bold>Introduction:</bold> Continuous Positive Airway Pressure (CPAP) therapy effectively treats obstructive sleep apnoea (OSA), but poor compliance hinders its efficacy. Aerophagia is thought to be a common side-effect affecting compliance, but little is known about its prevalence or severity. This study focuses on GI symptoms in newly diagnosed OSA patients. <bold>Methods:</bold> Three year prospective study at a UK tertiary sleep centre, on patients with moderate-severe OSA initiating CPAP therapy. Patients, chosen randomly, initially used Auto CPAP and transitioned to fixed pressure on day 7. Data was collected between March 2021 and Feb 2024 with assessments on day 0, day 7, 8 weeks, and 3 years, conducted through in-person and telephone interviews. We collected the following data at the 4 pre-specified time points: ·Epworth sleepiness score ·SF36 ·FOSQ-10 ·Gastrointestinal Symptom Rating Scale (GSRS) questionnaire <bold>Results:</bold> 50 participants were mostly male (71%)aged 27 to 82,with a median ESS score of 11. OSA severity varied:50% severe, 33% moderate, and 17% mild. Median CPAP pressure was 13 and median CPAP usage was 6 hours 15 minutes. Post-CPAP, FOSQ-10 and SF-36 showed improved well-being.GSRS scores indicated a high number of patients had baseline symptoms pre-CPAP without a formal GI diagnosis. There was no significant change in GSRS scores over 3 years although long term data was only available for 9 patients. <bold>Conclusion:</bold> Before CPAP treatment, patients often suffer from unaddressed GI symptoms and follow-up at 8 weeks and 3 years suggest no significant changes in GSRS scores, albeit with a smaller cohort. Therefore, CPAP therapy should not be attributed to GI symptoms described by patients who may have an underlying undiagnosed GI disorder.