0525 Association of Black Race with Positive Airway Pressure Therapy Adherence Among Veterans with Obstructive Sleep Apnea

Introduction Adherence to positive airway pressure (PAP) therapy for obstructive sleep apnea (OSA) remains poor, with up to 15% of patients refusing to continue treatment after a single night’s use and up to 50% abandoning therapy within one year. Prior studies have shown that blacks, who are disproportionately affected by cardiovascular disease, diabetes, obesity, and OSA, may also have reduced adherence to PAP. This study is the largest to date that examines whether black race among veterans with OSA is associated with PAP adherence measured at 30 days after initial PAP set-up. Methods All veterans diagnosed with OSA at one Department of Veterans Affairs sleep center who were prescribed a modem-enabled PAP device between January 2015 and November 2016 were included for analysis. PAP adherence was defined as ≥ 4 hour nightly usage for at least 70% of nights (binary variable) measured at 30 days from PAP set-up. Associations between PAP adherence and race were examined with chi-square tests. Logistic regression was used to examine the relationship between race and 30-day PAP adherence, controlling for gender, marital status, residual apnea-hypopnea index (AHI), mask leak, and early adherence. Results 3013 patients were identified, of which 2571 had modem data available for analysis (95% male, aged 59 ± 14 years, 45% married). 25% of participants were black, and 57% were white. 30-day PAP adherence was 50% overall, 42% among blacks, and 53% among whites. Black race was associated with reduced 30-day PAP adherence in both bivariate analysis (p