• Andreas Palm, Ludger Grote, Jenny Theorell-Haglöw, Mirjam Ljunggren, Josefin Sundh, Bengt Midgren, and Magnus Ekström.
• Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden; Centre for Research and Development, Uppsala University, Region of Gävleborg, Gävle Hospital, Gävle, Sweden. Electronic address: andreas.palm@medsci.uu.se.
• Chest. 2021 Oct 1; 160 (4): 1481-1491.

BackgroundEarly identification of poor adherence to CPAP treatment is of major clinical importance to optimize treatment outcomes in patients with OSA.Research QuestionHow do socioeconomic factors influence CPAP adherence?Study Design And MethodsNationwide, population-based cohort study of patients with OSA receiving CPAP treatment reported to the Swedish quality registry Swedevox between 2010 and 2018 was cross-linked with individual socioeconomic data from Statistics Sweden. Socioeconomic factors associated with CPAP adherence were identified using a multivariate linear regression model, adjusted for age and sex.ResultsIn total, 20,521 patients were included: 70.7% men; mean age ± SD, 57.8 ± 12.2 years; BMI, 32.0 ± 6.1 kg/m2; apnea-hypopnea index, 36.9 ± 22.1; Epworth Sleepiness Scale, 10.4 ± 5.0; and median nocturnal CPAP use, 355 min (interquartile range, 240-420 min). Adherence after 1.3 ± 0.8 years of CPAP use was significantly (all P < .001) associated with civil status (married vs unmarried: +20.5 min/night), education level (high, ≥ 13 years vs low, ≤ 9 years: +13.2 min/night), total household income (highest/third/second vs lowest quartile: +15.9 min/night, +10.4 min/night, and +6.1 min/night, respectively), and country of birth (born in Sweden with one native parent/born in Sweden with two native parents vs being born abroad: +29.0 min/night and +29.3 min/night, respectively).InterpretationCivil status, educational level, household income, and foreign background predict CPAP adherence in a clinically significant manner and should be considered when treating OSA with CPAP.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

29 keywords...

hide…