0742 Recording Duration of Home Sleep Test Predicts Adherence to CPAP Therapy

Aygun Asgarli; Junjie Liu

doi:10.1093/sleep/zsaf090.0742

Introduction Continuous positive airway pressure (CPAP) is the first-line therapy for obstructive sleep apnea (OSA), but CPAP adherence is challenging to many patients. As OSA is often diagnosed using self-directed home sleep test (HST), we hypothesized that the timings of HST recording can reflect the patient’s behavioral patterns and predict CPAP adherence. Methods We retrospectively collected data from our sleep clinic, which was the sole provider of HST within an academic tertiary-care center. Each patient took one night of HST using commercial devices with printed and verbal instructions to start HST recording when they “are ready to go to sleep” and stop recording when they “wake up”. Our clinic also instructed patients to start recording before 12 AM, and continue recording if they wake up during the night and plan to resume sleep. Among 712 patients who took HST within the last two years, were diagnosed with severe OSA and prescribed with CPAP, CPAP usage within one year after HST and other clinical data were available and studied for 360 patients. Results HST recording duration, start time and end time were 8.15 (7.27-8.78) hours [median (25-75 percentile)], 10:28 PM (9:39-11:18 PM) and 6:30 AM (5:52-7:17 AM), respectively. Longer HST recording duration was strongly correlated with both earlier start time (Spearman’s correlation coefficient r = -0.48; P < 3E-22) and later end time (r = 0.38; P < 2E-13). The daily CPAP usage time averaged on days when it was used was 6.22 (4.72-7.43) hours. Higher CPAP usage time was significantly correlated with longer HST recording duration (r = 0.21; P < 5E-5), and correlated with earlier recording start time (r = -0.13; P = 0.016), but not correlated with the recording end time (r = 0.01; P = 0.9). Patient’s age [52 (42-63) years], gender [58% male], body mass index [35.6 (31.0-42.4) kg/m2], apnea-hypopnea index [33.9 (24.9-52.4)] were all uncorrelated with either HSAT recording duration or CPAP usage time (P > 0.05). Conclusion HST recording duration and start time are readily available clinical data that can be harnessed to predict CPAP adherence at the time of OSA diagnosis, which may improve clinical outcomes.

0742 Recording Duration of Home Sleep Test Predicts Adherence to CPAP Therapy

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