0528 THE INFLUENCE OF PRE-TREATMENT HEALTH BELIEFS ON THE TRAJECTORY OF PAP USE DURING THE FIRST 12 WEEKS OF TREATMENT

• Published in: Sleep (New York, N.Y.) N.Y.), 2017-04, Vol.40 (suppl_1), p.A197-A197
• Main Authors: Wallace, DM, Reina, S, Amiel, C, Martinez, J, Wohlgemuth, WK
• Format: Article
• Language: English
• Subjects: Sleep apnea
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleepj/zsx050.527

Abstract Introduction: Data are equivocal on whether pre-treatment health beliefs (Risk Perception [RP], Outcome Expectancies [OE], and Self-Efficacy [SE]) about obstructive sleep apnea (OSA) and positive airway pressure (PAP) predict treatment adherence. However, limited research has examined the association of these health beliefs on the trajectory of PAP use. Our aim was to determine if pre-treatment RP, OE, and SE influenced the trajectory of PAP adherence in US veterans. Methods: Consecutive PAP-naïve OSA patients (n=185, 94% men, 42% black) attended the Miami VA sleep clinic to receive PAP and complete baseline questionnaires. Social cognitions about OSA and PAP were assessed with the Self-Efficacy Measure for Sleep Apnea (SEMSA). Patients returned for follow-up and adherence download. Outcomes were weekly averages of PAP use (mins). Models were fitted for the initial 12 weeks of treatment and time-centered at week 1. We used longitudinal multi-level modeling to characterize the influence of RP, OE, and SE on the trajectory of this outcome. Models were adjusted for relevant covariates (age, race, apnea-hypopnea index, sleepiness, insomnia, depression, and prescribed pressure). Results: During initial use (at week 1), pre-treatment RP, OE, and SE were positively associated with more PAP use. A 1-point increase (on a 4-point scale) was associated with a 42 min increase (p=0.04) in PAP use for RP (p=0.04), 62 min increase in PAP use for OE (p