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Is Bilevel Positive Airway Pressure (BPAP) an Effective Salvage Therapy for Obstructive Sleep Apnea (OSA) Patients Who Fail CPAP Therapy? This abstract describes using BPAP as an alternative for patients who fail CPAP. BPAP is an accepted treatment modality for OSA. OSA patients fail CPAP due to intolerance (unwillingness to continue therapy) or for whom CPAP was ineffective (persistent OSA or uncontrolled symptoms on therapy). After initial acceptance, Waldhorn states that 19 to 37% of OSA patients abandon CPAP treatment. 92 patients were placed on BPAP due to intolerance (72), ineffectiveness (9), and combined (4). 77 of the 92 had adherence data. Initial BPAP acceptance was 69 of the 92 or 75%. Adherence to BPAP therapy at one month was 42 of the 77 or 56%. Adherence to BPAP therapy at three months was 40 of the 77 or 57%. Adherence to BPAP therapy at 6 months was 37 of the 77 or 48%. Author's Conclusion: BPAP is an effective salvage therapy for about 50% of patients who do not tolerate CPAP therapy or for whom CPAP is not effective in treating OSA. There is a decline in BPAP use over 6 months in patients who initially accept BPAP as salvage therapy for OSA. S Szumstein, CW Atwood, PJ Strollo, MH Sanders. ATS/ALA ABSTRACT 1999.