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Abstract Introduction Positive airway pressure (PAP) therapy is first line treatment for obstructive sleep apnea (OSA). Challenges however exist in regard to optimal PAP adherence. Patterns of PAP adherence in the first month of device use can predict long-term adherence. We investigated the corelation between immediate PAP acceptance, measured by the morning PAP titration questionnaire (MPQ), administered immediately after the titration, and the initial 90-day PAP adherence. Methods We performed a retrospective review of patients who completed a PAP titration between January and June 2023 at Memorial Hermann Sleep Disorders Center - Texas Medical Center. Initial 90-day adherence (defined as usage ≥4 hours/night for ≥70% of nights) was obtained on each patient. The patients were grouped based on optimal adherence (Group 1) versus non-adherence (Group 2). The MPQ score was obtained for each patient (completed on the morning after the titration). The MPQ included 4 questions (sleep quality, morning alertness, PAP tolerance, likelihood of device usage) with each affirmative response receiving 1 point. An MPQ score of ≥3 was established as significant for PAP acceptance. Results A total of 20 subjects were analyzed with the following characteristics: Group 1 - N 10 (7 men, 3 women), mean age 66 years, mean AHI 43/hour of sleep. Group 2 - N 10 (8 men, 2 women), mean age 63 years, mean AHI 35/hour of sleep. In Group 1, 80% (8 patients) had a score ≥3 compared to 50% patients (5 patients) in Group 2. MPQ scores of 3 and 4 conferred the highest 90-day adherence (62% and 81% respectively). A significant MPQ score also translated into an 82% positive predictive value for PAP adherence in the initial 90 days. Conclusion Our results show that patients with a significant MPQ score of ≥3 post-PAP titration are more likely to adhere to PAP therapy than those with non-significant scores and this can hence be used to predict immediate (and potentially long-term) adherence patterns. This simple questionnaire can be implemented to guide strategically timed early follow up and interventions (amongst those who score 3) to best utilize limited sleep resources and reduce the prevalence of PAP non-adherence. Support (if any)
Abdallah et al. (Sat,) studied this question.