0611 A Head Start: Identifying Factors Affecting Initial Auto-Adjusting Positive Airway Pressure Therapy Compliance and Clinic Follow-Up for OSA Treatment

Abstract Introduction Automatic-adjusting positive airway pressure therapy (APAP), an increasingly popular OSA treatment, offers greater access to non-invasive treatment with efficacy dependent on device compliance. Characteristics affecting initial-compliance are understudied and could be used to better guide OSA treatment initiation. This study analyzes how these characteristics impact therapy compliance and follow-up. Methods ResMed therapy compliance and chart data, including demographic, and subjective OSA markers from USC Keck Medical Center patients diagnosed with OSA on HSAT/PSG started on APAP without an initial titration study were collected from January 2017- December 2025. Preliminary data of 100/3569 patients were included in uni- and multi-variate analysis using R-Studio comparing therapy non-compliant versus compliant patients and those lost to follow-up versus those who were not at initial 30 and 90 days as well as 30 days after first follow-up. Compliance was defined as 4 hours of use at ≥70%. Results Our cohort was predominantly middle-aged (53±15.4), male (59%), white (43%), and English-speaking, with their average BMI, AHI, and ESS being 31.2±7.5, 24.5±18.8, and 8.84±5.6, respectively. A significant proportion had hypertension (49%) and hyperlipidemia (40%). Univariate analysis demonstrated Hispanic patients were significantly less likely to be compliant (OR=5.73 p=0.036) than non-Hispanic patients, with no significant difference with gender or age. 30-day compliance was associated with 90-day compliance (OR=55.4, p 0.001). While pre-APAP AHI and post-APAP AHI were not statistically different between genders, the reduction of AHI post-APAP was significantly higher in males than in females (24.4±19.9 vs. 14.6±22.2, p=0.042). Patients lost to follow-up had greater residual-AHI than those who did not (10.60±19.56 vs 2.29±2.46, p=0.022). When controlling demographic and patient characteristics on logistic multivariable regression model, increased maximum pressure is associated with increased overall compliance (OR=1.28, 95% CI 1.04-1.58, p=0.022). Conclusion These preliminary findings would improve identification of patients who will benefit from APAP. Female and Hispanic patients could represent a more vulnerable population to poor compliance. Those with lower maximum pressures on initial compliance-data could represent people not tolerating therapeutic pressure levels, at risk of poor compliance and loss to follow-up. These patients could be considered for alternative therapies or prior formal titration study with closer follow-up/outreach, preventing patient attrition. Support (if any)