Home vs sleep lab adaptation of NIV/CPAP: real-world outcomes in a tertiary hospital cohort

Non-invasive ventilation (NIV) and CPAP can be initiated either at home or in a sleep laboratory, aiming to optimize adherence and outcomes. Home initiation offers convenience and lower costs, while lab initiation ensures close monitoring. Evidence on whether adaptation site affects long-term adherence, efficacy, or survival is limited. We retrospectively analyzed patients initiated on NIV/CPAP during hospital admission in 2024, classified by adaptation site (home vs lab). Outcomes were adherence (≥4 h/night, mean hours), efficacy (residual AHI, mean SpO₂, T90), and mortality. Group comparisons used chi-square or Mann-Whitney. Of 157 patients (mean age 69.3 years, 54.1% male; 56.7% OSA, 35.7% non-OSA), 86 (54.8%) were adapted at home and 71 (45.2%) in-lab. Lab patients had more nightly use hours (8.0 vs 5.0 h, p