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Sleep Disorders |

Claustrophobia and Continuous Positive Airway Pressure Adherence

Patricia Dettenmeier, MSN; Joseph Espiritu, MD
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Saint Louis University, St. Louis, MO


Chest. 2013;144(4_MeetingAbstracts):987A. doi:10.1378/chest.1691903
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Abstract

SESSION TITLE: Sleep Disorders II

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Wednesday, October 30, 2013 at 02:45 PM - 04:15 PM

PURPOSE: Continuous positive airway pressure (CPAP) adherence may be affected by many psychological factors including claustrophobia. The aim of this prospective cohort study was to determine whether claustrophobia affected CPAP adherence in patients with obstructive sleep apnea (OSA).

METHODS: Patients undergoing a polysomnogram for suspected OSA were prospectively given a brief survey about claustrophobia including a question about how claustrophobic they felt (no claustrophobia vs. claustrophobia in enclosed spaces or claustrophobia when things were close to their face) and a 5-point Likert claustrophobia scale. Adherence was defined as use of CPAP on at least 70% of nights for at least 4 hours in the defined periods. We analyzed whether claustrophobia predicted CPAP adherence in the first 7 days, month 1, month 2, month 3, 90 days, or any 30 days in 90 days (yes/no compliant) using logistic regression. We also compared average hours of use during the same time periods from the machine download between the claustrophobic and non-claustrophobic groups using independent t-test.

RESULTS: Of the 214 participants (mean age 49±13yr, 46% male, Epworth 10.6±5.3, BMI 35±8kg/m2, AHI 16±21/hr, minSpO2 84±7%), 43.6% were claustrophobic. There was no difference in mean age, gender, Epworth Sleepiness and Fatigue Severity scores, BMI, AHI, minSpO2, and neck circumference between the claustrophobic and non-claustrophobic groups. Personal history of insomnia [OR=1.910, 95%CI: 1.065-3.425], stroke [OR=4.193, 95%CI: 1.102-15.959], family history of anxiety [OR=3.032, 95%CI: 1.111-3.717] were positively associated with claustrophobia. Gender, race, personal history of anxiety or depression, family history of depression, and morning headache were not associated with claustrophobia. Claustrophobia did not predict either CPAP adherence or average hours of CPAP use at day 7, months 1, 2, and 3, day 90, or any 30 days of compliance in 90 days.

CONCLUSIONS: Although insomnia, stroke, and family history of anxiety were associated with claustrophobia, claustrophobia did not predict CPAP adherence.

CLINICAL IMPLICATIONS: Claustrophobia should not preclude a therapeutic CPAP trial in patients with OSA.

DISCLOSURE: The following authors have nothing to disclose: Patricia Dettenmeier, Joseph Espiritu

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