Amy M. Sawyer|Tonya S. King|Alexandra L. Hanlon|Kathy Richards|Leon Sweer|Albert Rizzo|Terri E. Weaver
Risk assessment for CPAP nonadherence in adults with newly diagnosed obstructive sleep apnea: preliminary testing of the Index for Nonadherence to PAP (I-NAP)
Pennsylvania State University|Pennsylvania State University|University of Pennsylvania|George Mason University|Pulmonary Associates|University of Illinois at Chicago
identification risk continuous positive airway pressure therapy cpap nonadherence prior home treatment opportunity deliver targeted adherence interventions study objectives included following 1 test risk screening questionnaire prospectively identify cpap nonadherence risk among adults newly diagnosed obstructive sleep apnea osa 2 reduce questionnaire minimum item set effectively identifies 1month cpap nonadherence 3 examine diagnostic utility screening index prospective longitudinal study two clinical sleep centers usa included adults newly diagnosed osa n 97 ahi 5 eventsh polysomnogram psg consecutively recruited participate baseline participant osa characteristics collected risk screening questionnaire administered immediately following cpap titration polysomnogram onemonth objective cpap use collected predominantly white 87 males 55 females 45 obesity bmi 383 kgm2 sd 93 severe osa ahi 368 sd 197 included onemonth cpap use 425 hnight sd 235 nineteen questionnaire items inap reliably identified nonadherers defined 4 hnight cpap use wald x 28 3467 p 00001 roc auc 083 95 ci 074091 optimal score cut point inap screening questionnaire determined maximize sensitivity 87 maintaining specificity 60 63 risk screening questionnaire employed immediately titration psg may reliably identify cpap nonadherers permit delivery targeted interventions prevent reduce nonadherence novel approach may enhance costeffectiveness care permit appropriate allocation resources cpap adherence