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 journalArticle

30 Citations (Scopus)

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

Fingerprint

Continuous Positive Airway Pressure
Veterans
Hispanic Americans
Sleep
Obstructive Sleep Apnea
Sleep Initiation and Maintenance Disorders
Polysomnography
Sleep Apnea Syndromes
Acculturation
Ethnic Groups
Cognition
Personality
Therapeutics
Anxiety
Prospective Studies
Depression

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 journalArticle

@article{cb2dbca777714ce2a9a2b9030c24b895,
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",
month = "3",
day = "1",
doi = "10.1007/s11325-012-0702-6",
language = "English",
volume = "17",
pages = "351--363",
journal = "Sleep and Breathing",
issn = "1520-9512",
publisher = "Springer Verlag",
number = "1",

}

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 -