Does Knowing Someone Using CPAP Equate to Better Inpatient CPAP Therapy Adherence Within an Obese Population? A Retrospective Study

Abstract

Background: West Virginia has the highest prevalence of obesity in the US, with approximately 38% of its adult population classified as obese based on BMI in 2020. Obesity is a major risk factor for OSA, a common sleep disorder characterized by repeated episodes of upper airway obstruction during sleep. CPAP is a commonly used therapy for OSA. Adherence to CPAP can be challenging for some patients, particularly during inpatient stays. Adherence to CPAP is defined per Medicare guidelines as usage of greater or equal to 240 min. This study aims to evaluate whether having a personal connection to someone who uses CPAP is associated with better inpatient CPAP adherence for patients with OSA in WV.

Methods: IRB 2009120369 This study retrospectively reviewed the medical charts of 52 patients who had received inpatient CPAP for sleep apnea. The study collected the following data from each patient: apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and inpatient CPAP usage in min. Patients with an AHI or ODI less than 5 were excluded from the study to ensure that only patients with clinically significant sleep apnea were included. The patients were also divided into two groups based on whether they reported knowing someone who used CPAP.

Results: A total of 52 patients with a mean BMI 40.4 were included in the analysis, with 30 patients reporting knowing someone who used CPAP, while 22 did not. The mean inpatient CPAP usage for patients who knew someone who used CPAP was 300.77 min (SD = 111.76), while the mean usage for patients who did not know someone who used CPAP was 314.72 min (SD = 104.37). The difference in mean usage between the two groups was not statistically significant (P = .64). Patients who did not know someone who used CPAP had a mean AHI of 28.63 or a mean ODI of 34.99, while patients who knew someone who used CPAP had a mean AHI of 25.14 or a mean ODI of 42.83.

Conclusions: This study suggests that prior knowledge of CPAP use, does not significantly affect inpatient CPAP usage. The mean inpatient CPAP usage was similar for both groups. However, given the complex relationship between prior knowledge of CPAP and inpatient CPAP usage, healthcare providers should take a comprehensive approach to addressing patient concerns and promoting the benefits of CPAP, regardless of the patient's prior knowledge or experiences with the treatment. This study highlights the need for further research to understand the impact of prior knowledge of CPAP on inpatient CPAP usage.