Age and sex differences in longitudinal CPAP adherence patterns.

Area of Science:

• Sleep Medicine
• Respiratory Therapy

Background:

• Obstructive sleep apnea (OSA) is a common condition requiring long-term treatment.
• Continuous positive airway pressure (CPAP) is a primary therapy for OSA, but adherence can be challenging.

Purpose of the Study:

• To investigate long-term adherence to CPAP therapy in adult OSA patients.
• To identify associations between age, sex, residual apnea-hypopnea index (AHI), and longitudinal CPAP compliance.

Main Methods:

• Retrospective observational analysis of 208 adult OSA patients.
• CPAP compliance data collected at baseline and follow-up (mean 567.8 days).
• Statistical analyses included paired t-tests and hierarchical linear regression.

Main Results:

• Overall percent compliance remained stable, but median nightly use declined significantly (p < 0.001).
• The proportion of patients meeting ≥70% adherence decreased from 97.1% to 79.3%.
• Women and patients <50 years showed greater reductions in compliance; older adults and men had higher median compliance.

Conclusions:

• While overall percent compliance is stable, long-term CPAP adherence declines in nightly usage and meeting adherence thresholds.
• Younger women (<50 years) are particularly vulnerable to decreased CPAP adherence over time.
• Residual AHI and comorbidities did not significantly impact adherence outcomes.