Untreated Sleep Apnea: An Analysis of Administrative Data to Identify Risk Factors for Early Nonadherence

Abstract

This study adds to existing knowledge about risk factors for nonadherence with sleep testing and treatment initiation following preauthorization. Health plans and providers should develop strategies to better engage patients with higher risk of nonadherence.

Evaluating the effect of an educational intervention on the adherence rate to sleep study: A multi-centered stratified randomized controlled trial

“…Thus, the geographical distance from the test administration center could be far [ 15 ]. Other related literature also raised this issue as a barrier to sleep test administration [ 26 , 27 ].…”

Incomplete control of obstructive sleep apnoea with continuous positive airway pressure therapy: Time for a personalized therapy approach?

“…Therapeutic success for CPAP therapy is generally defined as a reduction in the apnoea–hypopnoea index (AHI) to below 5 events/h with concurrent improvement in symptoms (including daytime sleepiness, snoring and quality of life) and satisfactory long‐term adherence. This is achievable in many patients, yet approximately 50% of patients either refuse CPAP therapy or are non‐adherent . Others are compliant with therapy but persistently demonstrate a residual AHI ≥5 events/h indicating suboptimal control.…”

“…It has been previously shown that males usually require a higher pressure on CPAP therapy for a given severity of OSA compared to females; higher pressure may, in turn, contribute to an elevated residual AHI. Similarly, it is known that those with cardiac disease usually have fewer symptoms of OSA and thus can be less tolerant of CPAP therapy . OSA patients with co‐morbid cardiac disease are also more likely to develop central sleep apnoeas.…”