Demographic and Sleep Study Factors Influencing Short-Term Adherence to Positive Airway Pressure Therapy in Obstructive Sleep Apnea

초록

Objective: Positive airway pressure (PAP) therapy effectively treats obstructive sleep apnea (OSA), yet adherence to the therapy presents significant challenges. This study identifies demographic and sleep study factors that influence short-term adherence to PAP therapy among patients with OSA by comparing data from adherent and non-adherent groups. Methods: Patients diagnosed with OSA via polysomnography who commenced PAP therapy after titration were divided into adherent and non-adherent groups. We employed propensity score matching in a 1:1 ratio based on age, gender, and body mass index (BMI), including a total of 150 patients in the analysis. Logistic regression analyses were conducted on all pertinent variables, excluding those with high multicollinearity. Non-significant variables were omitted from the final model, whose performance was evaluated using a receiver operating characteristic (ROC) curve, calculating the area under the curve (AUC). Results: Data from 150 participants (mean age 49.56 +/- 14.31 years, 79% males, mean BMI 28.96 +/- 5.11) were analyzed. Significant predictors of adherence included smoking status (odds ratio [OR] 0.267; 95% confidence interval [CI], 0.116-0.580; p = 0.001), Epworth sleepiness scale (OR 1.080; 95% CI, 1.004-1.166; p = 0.042), oxygen desaturation index (ODI) during titration (OR 0.906; 95% CI, 0.829-0.975, p = 0.015), and optimal PAP levels (OR 1.240; 95% CI, 1.007-1.119; p = 0.029). The ROC curve analysis indicated an AUC of 0.765, confirming the model's effectiveness in distinguishing between adherent and non-adherent patients. Conclusions: Adherence is negatively affected by smoking, whereas higher daytime sleepiness, optimal PAP levels, and a lower ODI during titration are associated with better adherence, underscoring the importance of personalized treatment approaches.

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