A196 SLEEP, Volume 40, Abstract Supplement, 2017 0525 UNMASKING PREDICTORS OF CONTINUOUS POSITIVE AIRWAY PRESSURE COMPLIANCE Smith P 1 , Lettieri C 1 , Raiciulescu S 1 , McGrath S 3 , Holley A 4 , Williams S 1 , Andrada T 1 , Collen J 1 1 Walter Reed National Military Medical Center, Bethesda, MD, 2 Walter Reed National Military Medical Center, Bethesda, MD, 3 Respira, Inc, Linthicum Heights, MD, 4 San Antonio Military Medical Center, San Antonio, TX Introduction: Continuous positive airway pressure (CPAP) remains the treatment of choice for obstructive sleep apnea (OSA). Although it is an effective treatment, adherence is poor. The literature has failed to identify treatment variables that consistently predict CPAP adherence. Methods: We performed a retrospective analysis of patients with OSA started on CPAP in our clinic over the past 7 years. We compared those who were compliant after 30 days of CPAP use with those who did not demonstrate regular use, defined as CPAP use for ≥4 hours per night on 70% of nights. We assessed several clinical and demographic variables for their relationship with CPAP adherence including self-identified race, gender, sedative-hypnotic use during the diagnostic polysom- nogram, mask type and brand. Differences between the groups were determined through the Chi-square test and Fisher’s Exact test. Results: Two-thousand and four patients were included in the analy- sis (91% men, mean age 45.2 years ±10.8, mean AHI of 19.79 ± 15.1, mean BMI of 29.49 ± 8.7). At 30 days following the initiation of CPAP therapy, overall compliance was 66%. Patients treated with a full face mask (56.6%) were significantly more compliant (68.2%) compared to those using a nasal interface (63.5%; p-value of 0.032, OR 1.2). In regards to the different mask brands, there was no statistical signifi- cance between the six separate interfaces included in the database. Self- identified Asian patients (2%) were also more likely to be compliant (77.8%; p-value of 0.000, OR 2.9) compared to other categories of race. The use of a sedative hypnotic, eszopiclone or zolpidem, during the polysomnogram was not indicative of compliance (p-value of 0.887). Conclusion: Our study demonstrates a statistically superior CPAP compliance at 30 days amongst patients treated with full face masks. Although statistically significant, these findings are not felt to be clini- cally relevant. However, this contradicts previously published data that full face masks negatively affect CPAP adherence. Additional investi- gation is warranted to further identify treatment variables associated with improved CPAP compliance. Support (If Any): 0526 ANNIE: THE VETERANS HEALTH ADMINISTRATION’S PERSONALIZED TEXT MESSAGE APPLICATION PROMOTES COMPLIANCE WITH POSITIVE AIRWAY PRESSURE Kataria LV, Sundahl CA, Skalina LM, Shah M, Pfeiffer MH, Balish MS, Chapman JC Washington DC Veterans Affairs Medical Center, Washington, DC Introduction: Estimated compliance with positive airway pressure (PAP) in the US population ranges from 40–50%. Our prior research revealed that PAP adherence in patients diagnosed with both traumatic brain injury (TBI) and obstructive sleep apnea (OSA) is significantly lower at 19%. Our objective was to demonstrate that personalized text message reminders improve adherence to PAP therapy in veterans with TBI and OSA. Methods: In a randomized, double-blind, controlled trial, nineteen veterans with chronic stage TBI and newly diagnosed OSA were randomized into either a reminder group, who received intensive edu- cation at the initial visit and nightly text message reminders to use PAP or to a standard-of-care (SOC) group. We piloted the Veterans Health Administration’s (VHA) secure text message application ANNIE. Text messages were personalized by inclusion of the patient’s name and the patient’s choice of message delivery time with the option to stop, pause, or resume messages at any time. Mean overall percent compli- ance and percent compliance greater than 4 hours per night was meas- ured at 7 and 30 days. Groups were compared using the Student’s t-test. Results: Mean overall percent compliance during the first 7 days was significantly greater in the reminder group (83.9% vs. 55.4%, p=0.04). Mean overall percent compliance at 30 days was also greater in the reminder group, but not statistically significant (58.9% vs. 36.9%, p=0.22). The reminder group demonstrated greater four hour threshold compliance at 7 days (48.2% vs. 30.4%, p=0.29) and 30 days (36.9% vs. 15.4%, p=0.13), although neither reached significance. None of the reminder group patients chose to stop or pause the nightly messages during the trial except one, who paused at day 28 due to travel. Conclusion: Personalized, automated text messages significantly improved PAP compliance during the first week of use with a trend toward increased PAP utilization in the first month. Personalized, automated reminders can be a useful tool to promote PAP adherence in patients with TBI. Further investigation with a larger sample is warranted. Support (If Any): Supported by the Department of Veterans Affairs, Veterans Health Administration, 2015 VISN 5 New Investigator Grant. 0527 ROLE OF SPOUSE IN CPAP ADHERENCE Batool-Anwar S 1 , Baldwin CM 2 , Fass S 3 , Goodwin JL 3 , Kushida CA 4 , Nichols D 4 , Quan SF 5 1 Brigham and women’s hospital, Boston, MA, 2 Arizona State University, Phoenix, AZ, 3 University of Arizona College of Medicine, Tucson, AZ, 4 Stanford University, Stanford, CA, 5 Brigham and Women’s Hospital, Boston, MA Introduction: Continuous positive airway pressure (CPAP) adher- ence among patients with obstructive sleep apnea (OSA) remains suboptimal. This study determined whether marital quality and spouse involvement affects adherence with CPAP therapy, and whether it dif- fers by gender. Methods: 194 subjects recruited from Apnea Positive Pressure Long Term Efficacy Study (APPLES) completed the Dyadic Adjustment Scale (DAS) 3 years after the study. The majority of participants were Caucasian men (84% and 74% respectively), with mean age of 56 years mean BMI of 31 kg/m2, and 62% had severe OSA. Inclusion required that subjects were married during APPLES and still married at the time of DAS administration. The DAS is a validated 32-item self-report instrument measuring marital dyadic consensus, satisfac- tion, cohesion, and affectional expression. Additionally, questions related to spouse involvement with general health and CPAP use were asked. CPAP compliance was defined as usage documented by device download ≥ 4 h/night. Results: Overall marital quality between the compliant and noncompli- ant subjects was not different; however, spousal involvement was asso- ciated with increased CPAP adherence at 6 months (p=0.01). Gender stratification demonstrated significance only among males (p=0.03). Three years after completing APPLES, 82 participants were still com- pliant by self-report. At this time point, spousal involvement was not associated with CPAP compliance even after gender stratification. Conclusion: Wife support of husband’s general health, but not hus- band’s support of wife’s general health is important in determining CPAP compliance in the first 6 months after initiation of therapy, but B. Clinical Sleep Science II. Sleep-Related Breathing Disorders Downloaded from https://academic.oup.com/sleep/article/40/suppl_1/A196/3781828 by guest on 19 September 2024