Direct Associations Between Demographic and Socioeconomic Indicators and Positive Airway Pressure Therapy in Adults with Obstructive Sleep Apnoea- A Scoping Review

OBJECTIVES: Obstructive sleep apnea (OSA) is a prevalent sleep disorder with multi-level adverse impacts. Although positive airway pressure (PAP) therapy is the gold standard treatment, sustained patient use remains a challenge. The aim of this study was to synthesize evidence on direct associations between demographic and socioeconomic indicators with PAP therapy in adults with OSA. METHODS: A scoping review following PRISMA-ScR protocol was conducted. PubMed, PsycINFO, CINAHL, and Cochrane databases were searched for publications between 1990 and February 2026 with key words associated with OSA, PAP use, and demographic (age, gender), and socioeconomic (education, employment status, occupational prestige, income and neighborhood advantage) indicators. Data were extracted on study design, follow-up, sample characteristics, PAP use definitions and measurement, and direct association results. Findings were summarized graphically and synthesized narratively. RESULTS: The majority of evidence suggested no direct association of PAP therapy use with age, gender, or education. There was limited evidence available for other SES indicators. CONCLUSIONS: Findings suggest that demographic characteristics alone may not be key determinants of PAP use. Future studies could further explore SES associations with PAP therapy use or move beyond examining direct associations to consider other types of associations e.g. moderating or interactive effects. PROTOCOL REGISTRATION: Open Science Framework (DOI 10.17605/OSF.IO/B9RT5).