The use of CPAP devices for obstructive sleep apnea (OSA) varies substantially by age and gender, with younger women who have OSA using CPAP the least, according to a new study. The study was posted online in the Abstract Issue of the American Journal of Respiratory and Critical Care Medicine (Abstract #6989: Epidemiology of CPAP Adherence in U.S. Adults).
“Most of what is known about CPAP adherence is based on participants in research studies, which generally include primarily middle-aged men, as well as those receiving care at academic centers,” says lead author Sanjay Patel, MD, MS, professor of medicine and epidemiology at the University of Pittsburgh and medical director of the UPMC Comprehensive Sleep Disorders Program, University of Pittsburgh Medical Center, in a release.
“We were interested in what CPAP adherence looks like in the general population to give insights into real-world situations involving other demographic groups who have been understudied. Because the focus of most research including interventions to increase adherence has been based on middle-aged men, we hypothesized that understudied groups would have worse outcomes.”
Patel and colleagues looked at telemonitoring data from a CPAP manufacturer for new patients over a three-year period—789,260 patients in all. Younger patients had the lowest adherence rate: 54.8% for patients ages 18-30, versus 79.3% for those ages 61-70. Women’s adherence rates were slightly lower overall, but the differences were greatest at younger ages. Eighteen to 30-year-old women were also more likely to abandon use of their CPAP devices within 90 days.
“The factors affecting age and gender are likely different,” Patel says. “Factors influencing adherence in younger people include having more chaotic lifestyles causing irregular sleep habits, as well as feelings of invincibility and less social support from a life partner. Women’s lower adherence rates may be influenced by less peer support due to OSA being viewed as a ‘male’ disease and a disease related to obesity, and possible differences in symptom severity and presentation.”
Patel suggests a number of ways to increase CPAP adherence among younger women, including spending more time educating patients about their CPAP device, behavioral therapy, peer/social support and openly discussing the challenges that CPAP presents to a particular patient. He also suggested videos of young women successfully using CPAP machines and publicizing famous women with sleep apnea (such as Amy Poehler).