Between Diagnosis and Follow-Through: The Untold Story of Sleep Apnea Patients

Chris Miller on August 26, 2025

For people diagnosed with obstructive sleep apnea (OSA), starting PAP therapy often feels like crossing a personal and emotional threshold. It’s a device that changes more than sleep—it reshapes routines, bedroom dynamics, even identity. For some, the transformation is life-changing in the best way: 

“I stalled forever, but now that I’ve started, I’ve never felt this rested. Total game-changer.” (Social Listening) 

Others remain tethered to the device but deeply resent it: 

“My CPAP machine is horrible. This has to be the least sexy thing in my life.” (Social Listening) 

But what about the people in the middle—the ones  who either cannot tolerate PAP therapy or simply aren’t interested in it?  These patients don’t tend to show up in case studies or testimonials. They don’t always complain online. Often, they just stop engaging—with treatment, with their HCP, with the entire process. 

And their numbers are significant. 

Understanding the Non-Adherent Majority 

A research study showed that nearly half of patients prescribed PAP either never started or discontinued within a year. In some groups, the drop-off is even higher. Among young adult women, adherence rates dip below 52%.  

Physical discomfort is part of the story. Mask fit, pressure, dryness, and claustrophobia all contribute. But the deeper reasons are emotional and behavioral—and often invisible. These patients aren’t necessarily rejecting care. But they may not see themselves—or their needs—reflected in what’s being offered. 

What Insomnia Teaches Us About PAP Avoidance 

To better understand what’s shaping their mindset, we looked to another condition as a proxy: people living with chronic insomnia. We turned to the Empathy Engine, our proprietary consumer intelligence platform that reveals the underlying behavioral and emotional drivers shaping their decision-making, to learn more.  

Here’s what the data reveals about this proxy group: 

  • 71% value ease, comfort, and emotional restoration—they want to feel better, but not at any cost. 

  • 56% report burnout from managing their condition, citing exhaustion from constant trial and error. 

  • 74% want to be active participants in their care, but feel stuck or unsupported. 

  • 60% have high health literacy, yet many experience cognitive dissonance—they know the "right" steps, but struggle to follow through in practice. 

This isn't passivity. It's emotional fatigue. And it’s often compounded by low trust in the system, fear of judgment, or prior negative experiences that quietly nudge them away from formal care. 

These individuals are often digitally capable and engaged, but socially cautious. They use apps, track symptoms, read the research—but they don’t always speak up. They’re not looking to be “compliant.” They’re looking to feel like themselves again. 

How HCPs Experience the Fatigue 

This quiet fatigue is not lost on healthcare providers, especially pulmonologists. They're operating in a system where up to half of their OSA patients have resigned or lost interest in care—sometimes before therapy ever truly begins.  

For these providers who are data-driven, detail-focused, and mission-oriented—traits revealed through our Mindset Engine, a proprietary behavioral intelligence platform that aims to understand how doctors make choices——this kind of loss is disorienting. 

They set a high bar, with 94% aiming for the best possible outcome in every decision. And many (82%) are motivated by the sense of fulfillment that comes from helping others—a signal that it’s not just part of the job, it’s part of how they stay connected to the work. When patients step away from care, it doesn’t just pause treatment—it interrupts the progress they work hard to create. 

Closing the Gap: From Resignation to Restoration 

The real gap in sleep apnea care isn’t just about diagnosis or engagement. It’s about relevance. Too often, what we offer doesn’t align with what patients are willing, able, or ready to act on. It’s a disconnect between the system’s expectations and the real-world conditions of people’s lives—and it shows up at every touchpoint. 

So what does that mean for what patients and providers actually need next? 

  • Ease and comfort that feel credible: Don’t just claim simplicity—deliver it. Emphasize what feels familiar, feasible, and low-friction right from the start. 

  • A path forward for the emotionally fatigued: Many patients aren’t unmotivated—they’re burned out. Offer steps that feel achievable, not overwhelming. Create space to re-engage without shame or judgment. 

  • Communication that reconnects, not just educates: Patients often already know what they “should” do. The real opportunity is to help them feel seen, supported, and reconnected to the why behind treatment. 

Because the gap between diagnosis and action isn’t just clinical—it’s behavioral. And to close it, we have to stop asking, “Why won’t they act?” And start asking, “How can we help them believe again?”