SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science I. Sleep Disorders – Breathing
significant predictors of compliance with various medical treatments.
Our goal was to evaluate the utility of pretreatment cognitive status, as
represented by EF and CF, for predicting adherence to continuous positive
airway pressure (CPAP).
Methods: Thirty five subjects (17 men, 18 women; M(age) = 46.5, SD =
14.0 years) were selected from archival data collected from 2008-2010.
Inclusion criteria were: a diagnosis of OSA by overnight polysomnography,
pretreatment completion of the Central Nervous System Vital Signs
(CNS-VS) computer administered NP test battery, and having objective
CPAP adherence data for at least 1 month. NP variables were reported as
Standard Score (M=100; SD=15) and CPAP adherence was defined as
average minutes of nightly use over the first 30 days of treatment.
Results: Using EF, CF and apnea-hypopnea index (AHI) as predictors
and CPAP adherence as the criterion, results from a linear regression
analysis revealed that the scores of EF and CF, when combined with the
AHI, contributed significantly to the variance of CPAP adherence, R =
.556, F(3) = 4.61, p = .009. EF scores alone are inversely predictive of
CPAP adherence, b* = -1.35, t(31) = -3.51, p < .05. CF scores alone were
also significantly predictive, b* = 1.13, t(31) = 2.89, p < .05, but the AHI
alone was not significantly predictive, b* = .151, t(31) = .948, p > .05.
Conclusion: Consistent with findings for other medical therapies, when
combined with AHI, EF and CF are useful predictors of CPAP adherence.
Further investigation of EF and CF in OSA patients can determine
if knowledge of pretreatment cognitive status can help identify patients
at risk for subtherapeutic adherence to CPAP.
0395
THE ROLE OF PATIENT PERCEPTIONS IN COMPLIANCE
WITH CONTINUOUS POSITIVE AIRWAY PRESSURE
Deloney CR 1 , Binns L 1 , Palmisano J 1 , O’Brien LM 1,2
1
Sleep Disorders Center, Department of Neurology, University of
Michigan Hospitals, Ann Arbor, MI, USA, 2 Department of Oral &
Maxillofacial Surgery, University of Michigan Hospitals, Ann Arbor,
MI, USA
Introduction: The high efficacy of continuous positive airway pressure
(CPAP) in treating obstructive sleep apnea (OSA) is limited by poor
CPAP compliance. The lack of data regarding predictors of CPAP compliance
has hindered the development of tailored interventions that can
be implemented before or during the critical first weeks of CPAP initiation.
The primary objective of this study was to determine whether
patient perceptions (perceived benefit of using CPAP, subjective knowledge
of the operating features of the CPAP machine, and perceived support
from the patient’s bed partner) predict CPAP compliance.
Methods: Adults diagnosed with OSA who initiated fixed CPAP after
undergoing a titration study were eligible to participate. Subjects completed
an anonymous questionnaire that encompassed both objective and
subjective experiences with CPAP as well as demographic and medical
history information. CPAP compliance was defined as ≥ 4 hours of use
per night for ≥ 6 nights per week.
Results: A total of 483 subjects (55.1% male) have been enrolled thus
far. Using logistic regression, perceived benefit was found to be an independent
predictor of CPAP compliance after adjusting for gender, comorbidities,
and potential adverse effects of CPAP (adjusted OR 1.70
(95% CI 1.16-2.25), p 18 years old, CPAP naive, and with a compliance
report within 3 months of initiating CPAP between 1/1/08 and
11/30/09 were eligible for inclusion. This was a retrospective chart review
recording demographics; OSAS severity; medical, psychiatric and
upper airway surgical history; Epworth score; presence of witnessed ap-
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SLEEP, Volume 34, Abstract Supplement, 2011