Impact of socioeconomic disparities on CPAP adherence.

Abstract

Study objectives: Socioeconomic disparities are known to have a significant impact on health outcomes including those related to obstructive sleep apnea (OSA). More recently, a metric known as area deprivation index (ADI), which combines 17 social determinants of health, has been used to better quantify this impact. We aim to examine the relationship between socioeconomic disparities and continuous positive airway pressure (CPAP) adherence among adults with OSA using ADI.

Methods: A retrospective study of patients with diagnosis of OSA and prescribed CPAP from October-December 2022 was performed. Patients were divided into more- or less-socioeconomically disadvantaged groups based on ADI, as well as social vulnerability index (SVI), which captures high school diploma rates. 30-day, 6-month, and 12-month CPAP adherence and follow-up rates were collected and compared across ADI/SVI quartiles.

Results: 536 patients met inclusion criteria. Patients from the most deprived areas (highest ADI) had significantly lower CPAP adherence than those from least deprived areas at all timepoints (P<0.05). Patients from areas with lower high school diploma rates had lower CPAP adherence (P<0.05).

Conclusions: Socioeconomic disparities appear to have a significant impact on CPAP adherence. People from areas that are more deprived and with lower high school diploma rates have lower therapy adherence rates. Patients within these groups may benefit from additional resources and/or closer follow up to improve adherence with treatment.