Determinants of continuous positive airway pressure adherence in a sleep clinic cohort of South Florida Hispanic veterans

Douglas Wallace; S. S. Vargas; Seth J Schwartz; M. S. Aloia; Shirin Shafazand

doi:10.1007/s11325-012-0702-6

Determinants of continuous positive airway pressure adherence in a sleep clinic cohort of South Florida Hispanic veterans

Douglas Wallace, S. S. Vargas, Seth J Schwartz, M. S. Aloia, Shirin Shafazand

Research output: Contribution to journal › Article

Original language	English
Pages (from-to)	351-363
Number of pages	13
Journal	Sleep and Breathing
Volume	17
Issue number	1
DOIs	https://doi.org/10.1007/s11325-012-0702-6
State	Published - Mar 1 2013

Keywords

Adherence
Continuous positive airway pressure
Hispanics
Obstructive sleep apnea
Veterans

ASJC Scopus subject areas

Otorhinolaryngology
Clinical Neurology

Cite this

Wallace, D., Vargas, S. S., Schwartz, S. J., Aloia, M. S., & Shafazand, S. (2013). Determinants of continuous positive airway pressure adherence in a sleep clinic cohort of South Florida Hispanic veterans. Sleep and Breathing, 17(1), 351-363. https://doi.org/10.1007/s11325-012-0702-6

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title = "Determinants of continuous positive airway pressure adherence in a sleep clinic cohort of South Florida Hispanic veterans",

abstract = "Purpose: There are little existing data on continuous positive airway pressure (CPAP) adherence in US Hispanic veterans with obstructive sleep apnea (OSA). Our aim was to describe determinants of 1-month adherence in a sleep clinic cohort of South Florida Hispanic veterans. Methods: Hispanic veterans referred to the Miami VA sleep clinic were recruited and completed questionnaires about sleep apnea risk, sleep quality, insomnia symptoms, sleepiness, depression/anxiety, acculturation, personality traits, and cognitions about OSA and CPAP. Individuals at risk for OSA were scheduled for baseline polysomnography (PSG), followed by in-lab CPAP titration or a trial of auto-CPAP. Participants with OSA accepting CPAP therapy were asked to return after 7 and 30 days of treatment for adherence verification and to repeat questionnaires. Results: One hundred twenty-four participants (94 % men) were enrolled with 114 completing overnight PSG. Eighty-six out of 95 participants (91 %) with sleep apnea syndrome or moderate to severe OSA accepted CPAP treatment. Fifty-nine participants completed both follow-up visits with a mean CPAP use at 30 days of 3.6 ± 2.0 h. The only independent predictor of 7-day mean daily CPAP use was the baseline Insomnia Severity Index while the best predictor of 30-day mean daily CPAP use was the 7-day mean daily use. Conclusions: Our study suggests that South Florida Hispanic veterans with OSA evaluated in a sleep clinic show poor CPAP adherence. Insomnia and poor early use predicted poor adherence overall. Larger prospective studies with other race-ethnic groups are needed to determine the role of ethnicity and race in CPAP adherence among US veterans with OSA.",

keywords = "Adherence, Continuous positive airway pressure, Hispanics, Obstructive sleep apnea, Veterans",

author = "Douglas Wallace and Vargas, {S. S.} and Schwartz, {Seth J} and Aloia, {M. S.} and Shirin Shafazand",

year = "2013",

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doi = "10.1007/s11325-012-0702-6",

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T1 - Determinants of continuous positive airway pressure adherence in a sleep clinic cohort of South Florida Hispanic veterans

AU - Wallace, Douglas

AU - Vargas, S. S.

AU - Schwartz, Seth J

AU - Aloia, M. S.

AU - Shafazand, Shirin

PY - 2013/3/1

Y1 - 2013/3/1

N2 - Purpose: There are little existing data on continuous positive airway pressure (CPAP) adherence in US Hispanic veterans with obstructive sleep apnea (OSA). Our aim was to describe determinants of 1-month adherence in a sleep clinic cohort of South Florida Hispanic veterans. Methods: Hispanic veterans referred to the Miami VA sleep clinic were recruited and completed questionnaires about sleep apnea risk, sleep quality, insomnia symptoms, sleepiness, depression/anxiety, acculturation, personality traits, and cognitions about OSA and CPAP. Individuals at risk for OSA were scheduled for baseline polysomnography (PSG), followed by in-lab CPAP titration or a trial of auto-CPAP. Participants with OSA accepting CPAP therapy were asked to return after 7 and 30 days of treatment for adherence verification and to repeat questionnaires. Results: One hundred twenty-four participants (94 % men) were enrolled with 114 completing overnight PSG. Eighty-six out of 95 participants (91 %) with sleep apnea syndrome or moderate to severe OSA accepted CPAP treatment. Fifty-nine participants completed both follow-up visits with a mean CPAP use at 30 days of 3.6 ± 2.0 h. The only independent predictor of 7-day mean daily CPAP use was the baseline Insomnia Severity Index while the best predictor of 30-day mean daily CPAP use was the 7-day mean daily use. Conclusions: Our study suggests that South Florida Hispanic veterans with OSA evaluated in a sleep clinic show poor CPAP adherence. Insomnia and poor early use predicted poor adherence overall. Larger prospective studies with other race-ethnic groups are needed to determine the role of ethnicity and race in CPAP adherence among US veterans with OSA.

AB - Purpose: There are little existing data on continuous positive airway pressure (CPAP) adherence in US Hispanic veterans with obstructive sleep apnea (OSA). Our aim was to describe determinants of 1-month adherence in a sleep clinic cohort of South Florida Hispanic veterans. Methods: Hispanic veterans referred to the Miami VA sleep clinic were recruited and completed questionnaires about sleep apnea risk, sleep quality, insomnia symptoms, sleepiness, depression/anxiety, acculturation, personality traits, and cognitions about OSA and CPAP. Individuals at risk for OSA were scheduled for baseline polysomnography (PSG), followed by in-lab CPAP titration or a trial of auto-CPAP. Participants with OSA accepting CPAP therapy were asked to return after 7 and 30 days of treatment for adherence verification and to repeat questionnaires. Results: One hundred twenty-four participants (94 % men) were enrolled with 114 completing overnight PSG. Eighty-six out of 95 participants (91 %) with sleep apnea syndrome or moderate to severe OSA accepted CPAP treatment. Fifty-nine participants completed both follow-up visits with a mean CPAP use at 30 days of 3.6 ± 2.0 h. The only independent predictor of 7-day mean daily CPAP use was the baseline Insomnia Severity Index while the best predictor of 30-day mean daily CPAP use was the 7-day mean daily use. Conclusions: Our study suggests that South Florida Hispanic veterans with OSA evaluated in a sleep clinic show poor CPAP adherence. Insomnia and poor early use predicted poor adherence overall. Larger prospective studies with other race-ethnic groups are needed to determine the role of ethnicity and race in CPAP adherence among US veterans with OSA.

KW - Adherence

KW - Continuous positive airway pressure

KW - Hispanics

KW - Obstructive sleep apnea

KW - Veterans

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JO - Sleep and Breathing

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SN - 1520-9512

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10.1007/s11325-012-0702-6