Socioeconomic Disparities in Positive Airway Pressure Adherence: An Integrative Review

Earl Charles Crew, William K. Wohlgemuth, Amy M. Sawyer, Natasha J. Williams, Douglas M. Wallace

Research output: Contribution to journalReview articlepeer-review


Nonadherence with positive airway pressure (PAP) therapy impedes the effectiveness of treatment and increases risk of mortality. Disparities in PAP adherence as a function of socioeconomic status (SES) are not well understood. A literature search identified 16 original publications meeting inclusion criteria that described effects of SES factors on objective PAP adherence; 69% of these articles found evidence of lower adherence as a function of SES. This integrative review provides a structured summary of the findings, highlights factors that may contribute to disparities among adult PAP users, and identifies future directions to improve equity in the management of OSA.

Original languageEnglish (US)
Pages (from-to)23-41
Number of pages19
JournalSleep Medicine Clinics
Issue number1
StatePublished - Mar 2021
Externally publishedYes


  • Adherence
  • Compliance
  • Positive airway pressure
  • Sleep
  • Sleep apnea
  • Socioeconomic disparities
  • Socioeconomic status

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Clinical Psychology
  • Clinical Neurology
  • Psychiatry and Mental health


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