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

William K. Wohlgemuth*, Diana Andrea Chirinos Medina, Samantha Domingo, Douglas M. Wallace

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)336-342
Number of pages7
JournalSleep Medicine
Volume16
Issue number3
DOIs
StatePublished - Mar 1 2015

Keywords

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

ASJC Scopus subject areas

  • Medicine(all)

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