Demographics, Sleep Apnea and Positive Airway Pressure (PAP) Treatment-Related Characteristics Associated with PAP Adherence: A Large Retrospective Community-Based Longitudinal Observational Study

Abstract

Despite many years of research, multiple factors have inconsistently shown to be associated with positive airway pressure (PAP) adherence. We conducted a retrospective observational study to evaluate the association between selected demographics, obstructive sleep apnea (OSA) - and PAP treatment-related factors, generally available, and objective PAP therapy adherence.We considered all consented individuals with OSA who purchased a PAP device from a registered vendor (Ottawa, Ontario) between 2011 and 2017 who had usage data available. PAP adherence was measured objectively as PAP use for at least 4 hours on at least 70% of days on treatment. In our cohort, 7,147/11,634 (61.5%) of participants were deemed adherent to PAP. The median percentage of days PAP therapy was used was 82% (IQR: 48-97%), and the median number of days PAP therapy was used for greater than 4 hours was 95 (IQR: 28-372). In multivariable logistic regression considering all variables available, the effect of body mass index, age, and minimum SaO2 at baseline sleep study were significantly associated with PAP adherence.