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Sleep Med. 2015 Mar;16(3):336-42. doi: 10.1016/j.sleep.2014.08.013. Epub 2014 Sep 17.

Attempters, adherers, and non-adherers: latent profile analysis of CPAP use with correlates.

Author information

1
Sleep Disorders Center, Bruce W. Carter VA Medical Center, Miami, FL, USA. Electronic address: william.wohlgemuth@va.gov.
2
Psychology, University of Miami, Coral Gables, FL, USA.
3
Psychology, Nova Southeastern University, Ft Lauderdale, FL, USA.
4
Sleep Disorders Center, Bruce W. Carter VA Medical Center, Miami, FL, USA; Neurology, University of Miami, Miami, FL, USA.

Abstract

STUDY OBJECTIVES:

To examine whether subtypes of continuous positive airway pressure (CPAP) user profiles could be identified, and to determine predictors of CPAP subgroup membership.

DESIGN:

A retrospective, correlational approach was used. Subjects attended clinic where a CPAP download was performed and questionnaires were completed. Additional information was obtained from the electronic medical record.

SETTING:

Miami VA Sleep Clinic.

PARTICIPANTS:

Obstructive sleep apnea patients (N = 207).

MEASUREMENTS:

Three adherence variables comprised the profile: % of nights of CPAP use, % of nights of CPAP use > 4 hours and average nightly use in minutes. Predictors included age, AHI, time since CPAP therapy was initiated, CPAP pressure, residual AHI, BMI, social-cognitive variables, insomnia, sleepiness, and psychiatric and medical comorbidities.

RESULTS:

Latent profile analysis was used to identify CPAP user profiles. Three subgroups were identified and labeled "Non-Adherers," "Attempters," and "Adherers". Non-Adherers (37.6% of the sample) used CPAP for an average of 37 minutes nightly, used CPAP 18.2% of nights and used CPAP > 4 hour 6.2 % of nights. Attempters (32.9%) used CPAP for 156 minutes on average, used CPAP 68.2% of nights and used CPAP > 4 hour 29.3% of nights. Adherers (29.5%) used CPAP for 392 minutes, used CPAP 95.4% of nights and used CPAP >4 hour 86.2% of nights. Self-efficacy, insomnia, AHI, time since CPAP was initiated, and CPAP pressure predicted CPAP subgroup membership.

CONCLUSION:

Sixty-seven percent of users (Non-Adherers, Attempters) had suboptimal adherence. Understanding CPAP use profiles and their predictors enable identification of those who may require additional intervention to improve adherence.

KEYWORDS:

Adherence; Continuous positive airway pressure; Latent profile analysis; Obstructive sleep apnea; Veterans

PMID:
25441752
DOI:
10.1016/j.sleep.2014.08.013
[Indexed for MEDLINE]

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