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Association Between Positive Airway Pressure Titration Sleep Data and Therapy Adherence in Patients with Obstructive
Ji Ho Choi1, Sungkyoung Shin2, Yeji Lee2
1Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170, Jomaru-ro, Bucheon 14584, Republic of Korea.
Medicina (Kaunas, Lithuania)
|September 27, 2025
Summary
Improved sleep efficiency and reduced wake after sleep onset during positive airway pressure (PAP) titration predict better PAP adherence in obstructive sleep apnea (OSA) patients. Objective sleep data offers insights into adherence. Keywords: PAP adherence, OSA, sleep efficiency, wake after sleep onset.
Area of Science:
- Sleep Medicine
- Respiratory Medicine
- Medical Technology
Background:
- Positive airway pressure (PAP) therapy is crucial for managing obstructive sleep apnea (OSA).
- Predictors of PAP adherence are well-studied, but the role of objective sleep scoring data from PAP titration remains underexplored.
- Understanding these objective parameters can optimize adherence strategies.
Purpose of the Study:
- To investigate the association between objective sleep parameters (sleep efficiency, wake after sleep onset, sleep latency) from PAP titration and short-term PAP adherence in OSA patients.
- To identify potential cut-off values for these sleep parameters that predict adherence.
Main Methods:
- A cohort of 227 OSA patients undergoing PAP titration was analyzed.
- Sleep efficiency (SE), wake after sleep onset (WASO), and sleep latency (SL) were measured during diagnostic polysomnography and PAP titration.
- Paired t-tests, binomial logistic regression, and chi-squared analysis were used to assess the relationship between sleep parameters and PAP adherence.
Main Results:
- Higher SE (83.3%) and reduced WASO (63.9 min) were observed during PAP titration compared to baseline.
- Increased SE (OR: 1.025) and decreased WASO (OR: 0.994) significantly predicted PAP adherence, though with modest predictive power (AUC 0.60-0.62).
- Optimal thresholds for adherence were ΔSE ≥ 2.39% and ΔWASO < -1.5 min. Improvements in SE and WASO were linked to higher adherence rates.
Conclusions:
- Objective improvements in sleep quality, specifically elevated SE and reduced WASO during PAP titration, are significantly associated with short-term PAP adherence in OSA.
- These objective sleep metrics can serve as valuable indicators for predicting and potentially improving PAP adherence.
- Further research may explore integrating these findings into clinical practice for personalized adherence interventions.
Keywords:
adherenceobstructive sleep apneapositive airway pressuresleep efficiencywake after sleep onsetMore Related Videos
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