Original ArticleAttempters, adherers, and non-adherers: Latent profile analysis of CPAP use with correlates

- Continuous positive airway pressure (CPAP) user profiles and their predictors were examined using a latent profile analysis.
- Three measures of adherence were downloaded CPAP.
- Three types of users were identified: attempters, adherers, and non-adherers.
- Modifiable correlates that distinguished these profiles included insomnia and self-efficacy.

Study objectivesTo examine whether subtypes of continuous positive airway pressure (CPAP) user profiles could be identified, and to determine predictors of CPAP subgroup membership.DesignA retrospective, correlational approach was used. Subjects attended clinic where a CPAP download was performed and questionnaires were completed. Additional information was obtained from the electronic medical record.SettingMiami VA Sleep Clinic.ParticipantsObstructive sleep apnea patients (N = 207).MeasurementsThree adherence variables comprised the profile: % of nights of CPAP use, % of nights of CPAP use > 4 hours and average nightly use in minutes. Predictors included age, AHI, time since CPAP therapy was initiated, CPAP pressure, residual AHI, BMI, social-cognitive variables, insomnia, sleepiness, and psychiatric and medical comorbidities.ResultsLatent profile analysis was used to identify CPAP user profiles. Three subgroups were identified and labeled “Non-Adherers,” “Attempters,” and “Adherers”. Non-Adherers (37.6% of the sample) used CPAP for an average of 37 minutes nightly, used CPAP 18.2% of nights and used CPAP > 4 hour 6.2 % of nights. Attempters (32.9%) used CPAP for 156 minutes on average, used CPAP 68.2% of nights and used CPAP > 4 hour 29.3% of nights. Adherers (29.5%) used CPAP for 392 minutes, used CPAP 95.4% of nights and used CPAP >4 hour 86.2% of nights. Self-efficacy, insomnia, AHI, time since CPAP was initiated, and CPAP pressure predicted CPAP subgroup membership.ConclusionSixty-seven percent of users (Non-Adherers, Attempters) had suboptimal adherence. Understanding CPAP use profiles and their predictors enable identification of those who may require additional intervention to improve adherence.