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.
| Original language | English |
|---|---|
| Pages (from-to) | 351-363 |
| Number of pages | 13 |
| Journal | Sleep and Breathing |
| Volume | 17 |
| Issue number | 1 |
| DOIs | |
| State | Published - Mar 1 2013 |
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Keywords
- Adherence
- Continuous positive airway pressure
- Hispanics
- Obstructive sleep apnea
- Veterans
ASJC Scopus subject areas
- Otorhinolaryngology
- Clinical Neurology
Cite this
Determinants of continuous positive airway pressure adherence in a sleep clinic cohort of South Florida Hispanic veterans. / Wallace, Douglas; Vargas, S. S.; Schwartz, Seth J; Aloia, M. S.; Shafazand, Shirin.
In: Sleep and Breathing, Vol. 17, No. 1, 01.03.2013, p. 351-363.Research output: Contribution to journal › Article
}
TY - JOUR
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
UR - http://www.scopus.com/inward/record.url?scp=84874194303&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84874194303&partnerID=8YFLogxK
U2 - 10.1007/s11325-012-0702-6
DO - 10.1007/s11325-012-0702-6
M3 - Article
C2 - 22528953
AN - SCOPUS:84874194303
VL - 17
SP - 351
EP - 363
JO - Sleep and Breathing
JF - Sleep and Breathing
SN - 1520-9512
IS - 1
ER -