Finances Not Primary Obstacle in CPAP Adherence

HealthDay News — Finances are not the primary obstacles responsible for reduced purchase of continuous positive airway pressure (CPAP) devices for patients with severe obstructive sleep apnea under a copayment health care system, according to a study published in the Annals of the American Thoracic Society.

Tetyana Kendzerska, PhD, from the University of Toronto, and colleagues examined the correlation between patient neighborhood income level and CPAP device purchase under a cost-sharing health insurance system. Patient data were linked to provincial health administrative data to determine CPAP equipment purchase, comorbidities, neighborhood income, and rural status.

The researchers found that 58% of the 695 participants with severe obstructive sleep apnea and excessive daytime sleepiness purchased a CPAP device. The likelihood of living in a higher-income neighborhood was increased for patients who accepted CPAP. The cumulative incidence of CPAP acceptance was 43 and 52%, respectively, for individuals in a low-income neighborhood (quintile 1) versus combined higher-income neighborhoods (quintiles 2 to 5) at 6 months (P = 0.05). Living in higher-income neighborhoods versus the lowest-income neighborhood correlated with a 27% increased chance of accepting CPAP after controlling for age and sex (hazard ratio, 1.27; 95% confidence interval, 0.98 to 1.64; P = 0.07).

“Living in an unfavorable neighborhood is not an obstacle to CPAP treatment among symptomatic patients with severe obstructive sleep apnea under a copayment health care system,” the authors write. “However, a potential 27% improvement in CPAP acceptance associated with higher neighborhood income is not inconsequential. Also, the overall CPAP acceptance rate was relatively low, suggesting that obstacles other than finances are primarily responsible.”


Kendzerska T, Gershon AS, Tomlinson G, Leung RS. The Effect of Patient Neighbourhood Income Level on the Purchase of Continuous Positive Airway Pressure Treatment among Sleep Apnea Patients. Ann Am Thorac Soc. 2015; doi:10.1513/AnnalsATS.201505-294OC.