American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Aug 2021
Neighborhoods with Greater Prevalence of Minority Residents Have Lower CPAP Adherence.
Rationale: Limited data suggest racial disparities in continuous positive airway pressure (CPAP) adherence exist. Objectives: To assess whether CPAP adherence varies by neighborhood racial composition at a national scale. Methods: Telemonitoring data from a CPAP manufacturer database were used to assess adherence in adult patients initiating CPAP therapy between November 2015 and October 2018. ⋯ Mean CPAP usage was similar across neighborhoods for the first 2 days, but by 90 days, differences in CPAP usage increased to 22 minutes (95% CI, 18-27 min) between neighborhoods with high versus low percentages of Black residents and 22 minutes (95% CI 17-27 min) between neighborhoods with high versus low percentages of Hispanic residents (P < 0.001 for both). Conclusions: CPAP adherence is lower in neighborhoods with greater proportions of Black and Hispanic residents, independent of education or poverty. These differences lead to a lower likelihood of meeting insurance coverage requirements for CPAP therapy, potentially exacerbating sleep health disparities.