0531 Excessive mask leak and its association with poor PAP compliance in women. A secondary analysis of the AWARE study

Abstract

Abstract Introduction Studied have shown that continuous positive airway pressure(CPAP) adherence is lower in women. However, understanding of the specific challenges faced by woman when starting therapy remains poor. Specifically, is there any relationship between leak and women’s characteristics that could influence adherence? Methods The AWARE-study is a longitudinal pilot-study with the objective to identify in women modifiable barriers to initiating/adhering to treatment over 3-months. Adherence was considered when using CPAP for a minimum 4-hours 70% of the nights. But, is there any association between leak, mask type and other patient’s characteristics that could influence adherence in women? This is a secondary analysis looking at leak as a consequence of poor adherence in women within the AWARE-study. We gathered data directly from the PAP-data-base and evaluated adherence within the first 3-months after starting therapy and usage at-present-time. We investigated leakage (>25 L/min) and gathered information about severity of OSA, age, BMI, and race. Our aims: to evaluate for leak as a cause of poor adherence and to identify characteristics that could potentiate leak in women. Results Data from 49 women from the AWARE-study between the ages of 28-85, with a recent diagnosis of OSA who started CPAP was analyzed. Adherence, leakage, age, OSA severity, and mask type was gathered. Chi-squared test of independence suggests a relationship between leakage and present adherence, Chi2(1)=11.34, p=0.001. Of those women experiencing high leakage, 83% were non-adherent to therapy. Logistic regression was run to compute an odds ratio with 95% CI. Those experiencing high leakage have about 92% times lower odds to still be compliant than those not experiencing high leakage [OR=0.08, 95% CI: 0.007, 0.478]. Overall, mask type relates to adherence, 72% of nasal mask wearers were still being adherent versus 38% when using facial masks. The prediction of adherence from leakage does not significantly differ across mask type. Age was found to be related to adherence; 57% of women under 50-years were not adherent to CPAP versus 26% in women over 50-years. Conclusion This information could guide us in suggesting strategies for better mask choosing and possibly to implement more specific strategies that can increase adherence in women. Support (if any)