A212 SLEEP, Volume 42, Abstract Supplement, 2019 B. Clinical Sleep Science and Practice II. Sleep-Related Breathing Disorders whether there was ≥4 h use on ≥70% days). Patients initially started on APAP were similarly compared with those initially started on CPAP. Results: 143 patients switched from APAP to CPAP had improve- ment in SWIFT (6.3 vs. 7.6, p<0.001) and adherence (79.9% vs. 74.5%, p=0.003), with more becoming adherent (84.6% vs. 69.9%, p=0.005). Epworth Sleepiness Scale (ESS) also improved. Before the switch, these 143 patients had higher SWIFT on APAP than patients who stayed on APAP, with no difference in adherence. 296 patients initially started on CPAP had no difference in SWIFT (6.6 vs 7.3, p=0.158), but had higher adherence (80.8% vs. 74.7%, p=0.009) than 213 patients started on APAP, with more being adherent (85.8% vs. 73.2%, p=0.001). Conclusion: Patients have better outcomes (sleepiness, adherence) on CPAP than on APAP. Added to other literature evidence that APAP is inferior to CPAP for improvement in blood pressure, heart rate variability, oxygen desaturation index and insulin resistance, and may cause more sympathetic overactivity, this should result in re-examination of the role of APAP. If APAP is used frst anyway, trouble tolerating it or an insuffcient clinical response should lead to consideration of a switch to CPAP based on a CPAP titration PSG. Support (If Any): 0530 ADHERENCE TO POSITIVE AIRWAY PRESSURE (PAP) DEVICES: FEASIBILITY OF A WEB-BASED SELF MANAGEMENT PROGRAM. Suzanne S. Dickerson, DNS 1 , Eric TenBrock, MD 2 , Patrica Smith, NP 2 , Misol KWon, BSN, PhD student 2 , Thomas Chacko, MSW 2 , Chin-Shang Li, PhD 2 , Grace E. Dean, PhD 2 1 School of Nursing, University at Buffalo, Buffalo, NY, USA, 2 University at Buffalo, Buffalo, NY, USA. Introduction: To support PAP adherence, a comprehensive and accessible self-management program is needed in the primary care setting to promote living with and adjusting to PAP treatment of obstructive sleep apnea (OSA). This study tested the usability and feasibility of a web-based program to support self- management, provider communication and motivation for individuals beginning PAP treatment. Methods: A mixed-method approach was used to follow a sam- ple of 20 newly diagnosed patients with OSA (Apnea/Hypopnea Index (AHI) of >10 and <5 central events/ hr.) who are beginning PAP treatment. After 1 week, the treatment group participants were interviewed by telephone to determine usability. The out- come was (% days of use >4 hours per night) at 1 month, accessed from PAP compliance reports. Analysis compared treatment group and standard care control group outcomes using Wilcoxon Rank- Sum test. A standard care group was matched for age, gender and severity. Results: Among 20 participants, the mean age was 48 (±11.3, median 52, range 30-61) years, 65% male, 95% white and a mean AHI of 41 (±25.6, median 29.1, range 14-85). Results indicated that compliance was 63% in the treatment group and 49% in the matched control (p= .228). Participants in the treatment group who viewed the website (n=14) had 80% compliance and those who did not participate (n=6) had 23% compliance (p=.005). Average minutes using the website was 71.6 (±73, median 48, range 2-244). Participants reported that the website provided compre- hensive, focused, well-organized information and useful tools to monitor their progress, and trouble-shoot their issues. Participants commented that on the website, users ‘stories helped them under- stand how long it would take to feel better and adjust to using the PAP. Breathe2Sleep™ website provided comprehensive and focused content that motivated their self-management. Conclusion: The Self-Management Program Website was useful in promoting adherence to PAP in newly diagnosed participants and would be a cost effective way to provide self-care information and tools to encourage patient engagement to improve adherence. Support (If Any): The Patrica Garman Fund, School of Nursing, University at Buffalo. 0531 PATIENTS WHO IMMEDIATELY STRUGGLE WITH CPAP: IDENTIFYING A PATIENT POPULATION IN NEED OF EARLY INTERVENTION Gina Merchant, PhD 1 , Amy Blase 1 , Leslee Willes 2 , Adam Benjafeld, PhD 1 1 ResMed, San Diego, CA, USA, 2 Willes Consulting Group, Inc., Encinitas, CA, USA. Introduction: It is well known that patients who immediately strug- gle with CPAP therapy have diffculty achieving CMS compliance (i.e., ≥4hrs per night for 70% of nights within a consecutive 30-day window by 90 days). This analysis sought to identify a usage thresh- old that identifes those who ultimately do not meet compliance. With the ultimate aim of intervening early and at scale, threshold selection also involved: considering the percent of new-to-therapy patients captured; maximizing the projected to be non-compliant patients without including too many patients who appear lacking in readiness to change. Methods: De-identifed data from a subset of the AirView data- base (ResMed Corp, San Diego) that included four US sleep clinics were used in the analysis. Patients were included in the analysis if they were naïve to therapy, enrolled in the US AirView data- base, and using continuous positive airway pressure (CPAP) to treat their obstructive sleep apnea (OSA) on a wirelessly-connected ResMed fow generator. Valid data were analyzed for adult patients (>18 years) enrolled between 30Apr2015 and 30Apr2018 which contained at least one session with device usage ≥1hr in the frst 7 days. Results: Of 18,391 patients in this group who started CPAP therapy during the study period, 4,717 (26%) used their device ≤3.5hrs cumulative nightly average by day 3. The distribution of usage hours among patients captured by this threshold was posi- tively skewed (1st quartile = 0.03) and highly variable (1.39±1.22). Ultimately, 45% (n = 1,678) of patients captured by this thresh- old were non-compliant, and the difference in mean usage hours at 90-days between compliant (4.94 ± 1.48) and non-compliant (1.34±1.20) patients was signifcant (t = 85.48, p < 0.001). Conclusion: Evaluating usage patterns of new-to-therapy patients identifes people who will struggle to achieve compliance, enabling early intervention which may help shift them onto a path of suc- cess. Further studies are planned, including a behavioral interven- tion that will target this now identifed population of strugglers. Support (If Any): ResMed 0532 MINDFULNESS-BASED STRESS REDUCTION FOR CLAUSTROPHOBIA ASSOCIATED WITH POSITIVE AIRWAY PRESSURE IN OBSTRUCTIVE SLEEP APNEA Amy M. Sawyer, Ph.D., R.N. 1,2,3 , Michael Gawrysiak, Ph.D. 4,5 , Tonya S. King, Ph.D. 6 , Alexa J. Watach, Ph.D., R.N. 3 , Downloaded from https://academic.oup.com/sleep/article/42/Supplement_1/A212/5450898 by guest on 26 January 2023