1239 An Estimate of Solid Waste Produced by CPAP Treatment in the United States

Abstract Introduction Obstructive sleep apnea is an increasingly common condition seen in sleep medicine with prevalence estimates of up to 1 billion patients globally. Treatment with CPAP machines is the mainstay of therapy for patients with moderate-severe OSA, but is resource intensive due to the need for complex electronic equipment and frequent supply refills. The United States healthcare system is estimated to produce.9 million tons of solid waste annually; however, it has not been determined how sleep medicine clinical practices contribute to this total. The purpose of this study was to estimate the total solid waste produced by the treatment of moderate-severe OSA with CPAP in the U.S. over a 10 year period. Methods We modeled waste generation under a steady-state CPAP-treated population (4.8 or 24 million patients), assuming an annual 15% exit/entry rate. Each new patient was assigned a CPAP machine at initiation; existing users contributed waste from ongoing consumable use. Waste calculations included machine and accessory weight (masks, tubing, filters). We evaluated scenarios by varying mask type distribution, tubing type (heated; non-heated), and machine/supply replacement schedules to create total waste estimates. Results The solid waste associated with treating 4.8 million U.S. patients with moderate-severe OSA over ten years ranged from 88.7 to 104.4 kilotons. Maximum waste occurred with heated tubing use, CMS replacement schedules, 5-year device replacement, regardless of mask mix (104.4-104.5 kilotons). Waste was reduced by 15% using lightweight tubing and extending device life to 7 years, and by 45% using a reduced replacement schedule modeled on French practice (2–4 masks/year, 1 tubing/filter/year, 1 water reservoir/year). Conclusion Treatment with CPAP is a resource intensive therapy that produces a significant amount of plastic and electronic waste annually, likely contributing to ongoing environmental and climate degradation. Extending CPAP machine and supply lifespan and selecting for lighter PAP supplies, such as non-heated tubing, can significantly reduce the waste associated with U.S. CPAP use. Support (if any)