SESSION TITLE: CPAP for OSA
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Sunday, October 27, 2013 at 03:00 PM - 04:00 PM
PURPOSE: To determine if Ford Insomnia Response to Stress Test (FIRST) questionnaire could predict CPAP compliance. FIRST questionnaire was developed and validated at Henry Ford Hospital to evaluate vulnerability to stress-related sleep disturbance and hyperarousal. It consists of nine questions related to stressful situations.
METHODS: Sixty patients filled out the FIRST questionnaire prior to their CPAP titration. Subsequently their first 30 days of data was assessed for compliance from the CPAP manufacturers’ online reports. Only new patients who were prescribed CPAP were included. Sleep latency, sleep efficiency, and other demographic variables were collected. Patients with missing data were omitted from the analysis.
RESULTS: FIRST scores showed poor relationship to CPAP compliance (p=0.42) and cannot be used as a predictor. In post hoc analysis, FIRST scores were divided into thirds and compared with each other in terms of average minutes of CPAP compliance (p=0.565). The CPAP compliance (223 minutes) on patients with the highest third of FIRST scores, which suggest increased sleep reactivity, was compared to the CPAP compliance (266 min) with patients with the lowest third of scores and an average 43 min difference in CPAP compliance was identified. This may be clinically relevant, but was not a significant difference (p=0.432).
CONCLUSIONS: No clear relationship between sleep reactivity and CPAP compliance was identified in this study. CPAP compliance has numerous confounding factors and thus it may be difficult to identify to what extent sleep reactivity affects compliance.
CLINICAL IMPLICATIONS: CPAP compliance remains a major hurdle for successful OSA management. It is difficult to predict which patients will be compliant and what may deter them. In our study, we hypothesized that sleep reactivity may lead to poor CPAP compliance. However, this study did not find a correlation between the two. This suggests that sleep reactivity may not be as important of a factor for compliance as initially thought. Further studies using different screening tools need to be done to rule out sleep reactivity as a cause for poor CPAP compliance.
DISCLOSURE: The following authors have nothing to disclose: Niraj Parikh, Chirag Popat, Rami Abboud, Luisa Bazan, Christopher Drake
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