Younger women less likely to adhere to CPAP therapy
Use of CPAP devices for obstructive sleep apnea varies by age and sex, with the lowest adherence in younger women, according to data scheduled for presentation at the American Thoracic Society International Conference.
“Most of what is known about CPAP adherence is based on participants in research studies, which are limited in the types of patients, focusing typically on middle-aged men and those receiving care at academic centers,” Sanjay R. Patel, MD, MS, medical director of the Comprehensive Sleep Disorders Program at University of Pittsburgh Medical Center and professor of medicine and epidemiology at University of Pittsburgh, told Healio Pulmonology.
Patel and colleagues conducted a study to provide insight on real-world CPAP adherence and demographic differences. The researchers analyzed telemonitoring data from a CPAP manufacturer database to identify new CPAP therapy users from November 2015 to 2018.
A total of 789,260 patients (mean age, 55 years; 58% men) were included.
Overall adherence in the first 90 days of therapy was 72.6%, according to the study abstract.
The researchers reported that younger age was associated with lower adherence to CPAP therapy, with adherence rates ranging from 54.8% among adults aged 18 to 30 years to 79.3% among adults aged 61 to 70 years (P < .001).
When the researchers examined adherence by sex, they found slightly lower adherence rates among women compared with men (71.6% vs. 73.4%). However, differences in CPAP adherence between men and women were greater in younger age groups. The rate of adherence was 50.7% for women aged 18 to 30 years vs. 57% for men the same age, compared with 78% for women aged 61 to 70 years vs. 80.3% for men the same age (P < .001 for age by gender interaction), according to the results.
In addition, women aged 18 to 30 years were more likely to stop using their CPAP therapy by 90 days compared with men the same age. At 90 days, the proportion of women with mean nightly CPAP use of less than 1 hour was 26.2% compared with 20.4% for men (P < .001).
“While we anticipated CPAP adherence in women, particularly younger women, would be lower, we were struck by how much lower adherence levels are in this group,” Patel told Healio. “Now that we have highlighted how poorly young women do with CPAP, it is important for future research to understand what the reasons for this poorer outcome are.”
Strategies to increase CPAP adherence in younger women might include increased education about the devices, behavioral therapy, peer/social support, open discussion of the challenges CPAP therapy presents to a particular patient, and greater awareness of other young women and public figures with sleep apnea, according to Patel.