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

D. M. Wallace, S. S. Vargas, S. J. Schwartz, M. S. Aloia, S. Shafazand

Research output: Contribution to journalArticle

33 Scopus citations

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 languageEnglish (US)
Pages (from-to)351-363
Number of pages13
JournalSleep and Breathing
Volume17
Issue number1
DOIs
StatePublished - Mar 1 2013

Keywords

  • Adherence
  • Continuous positive airway pressure
  • Hispanics
  • Obstructive sleep apnea
  • Veterans

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology

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