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Introduction This study assesses the impact of national guideline changes made by NICE (National Institute for Health and Care Excellence) in the UK in 2021 to recommend Continuous Positive Airway Pressure (CPAP) therapy for patients diagnosed with mild Obstructive Sleep Apnoea (OSA) who are symptomatic (e.g. excessively sleepy). Specifically, we monitor the success of treatment in terms of compliance, and look to see which factors influence compliance.Method We collected data from those diagnosed with mild OSA (Apnoea-Hypopnoea Index (AHI)/Oxygen Desaturation Index (ODI) ≥5 and ≤15) between January 2022-May 2023 and given CPAP for symptomatic relief, totalling 124 patients (458 observations). We monitored compliance during follow up appointments at intervals of two weeks, three months, six months, and one year following setup, assessing both categorical compliance (≥70% nights ≥4 hours), and continuous compliance (average hours/night). Specifically, we assessed whether age, gender, BMI, Epworth Sleepiness Score (ESS), and symptoms at initial consult (snore, morning headache, witnessed apnoeas, nocturnal choking), influenced compliance in this cohort.Results We found a significant reduction in categorical compliance over time, but not when measuring average hours of CPAP use ( figure 1A). The average 3-month compliance of mild symptomatic patients was 27%, which is within the range found in the literature among OSA patients generally. The measures BMI, ESS, and age did not significantly correlate with compliance in this sample. The number of symptoms at initial consult did correlate with both categorical and continuous compliance, but this was gender-specific; male patients with more presenting symptoms showed higher compliance, but this was not the case in women (figure 1A and B).Abstract P29 Figure 1(A) CPAP categorical compliance over time, and model predicted; (B) categorical compliance and (C) average CPAP hours used depending on number of presenting symptoms for male and female mild OSA patientsConclusion Compliance declining over the first year of treatment reinforces the importance of early advice and support in these patients. As the aim of CPAP therapy for mild OSA is symptomatic benefit, self-management of treatment should be encouraged. Number of symptoms at initial consult predicted compliance in men, but not women. This could be due to a lot of the ‘typical’ symptoms associated with OSA, including those used in this study, being male-biased. Therefore, future studies should ensure inclusion of symptoms typical to women too (e.g. tiredness, low mood, insomnia).