Low socioeconomic status is a risk factor for CPAP acceptance among adult OSAS patients requiring treatment.
OBJECTIVE
To evaluate whether socioeconomic status (SES) has a role in obstructive sleep apnea syndrome (OSAS) patients' decision to accept continuous positive airway pressure (CPAP) treatment.


METHODS
Cross-sectional study; patients were recruited between March 2007 and December 2007.


METHODS
University-affiliated sleep laboratory.


METHODS
162 consecutive newly diagnosed (polysomnographically) adult OSAS patients who required CPAP underwent attendant titration and a 2-week adaptation period.


RESULTS
40% (n = 65) of patients who required CPAP therapy accepted this treatment. Patients accepting CPAP were older, had higher apnea-hypopnea index (AHI) and higher income level, and were more likely to sleep in a separate room than patients declining CPAP treatment. More patients who accepted treatment also reported receiving positive information about CPAP treatment from family or friends. Multiple logistic regression (after adjusting for age, body mass index, Epworth Sleepiness Scale, and AHI) revealed that CPAP purchase is determined by: each increased income level category (OR, 95% CI) (2.4; 1.2-4.6), age + 1 year (1.07; 1.01-1.1), AHI ( > or = 35 vs. < 35 events/hr) (4.2, 1.4-12.0), family and/or friends with positive experience of CPAP (2.9, 1.1-7.5), and partner sleeps separately (4.3, 1.4-13.3).


CONCLUSIONS
In addition to the already known determinants of CPAP acceptance, patients with low SES are less receptive to CPAP treatment than groups with higher SES. CPAP support and patient education programs should be better tailored for low SES people in order to increase patient treatment initiation and adherence.
Simon-Tuval
Tzahit
T
Sleep-Wake Disorders Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Reuveni
Haim
H
Greenberg-Dotan
Sari
S
Oksenberg
Arie
A
Tal
Asher
A
Tarasiuk
Ariel
A
D000328:Adult; D000368:Aged; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure / Q000191:economics* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D005382:Financing, Personal / Q000191:economics; D006801:Humans; D007182:Income; D007557:Israel; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010353:Patient Education as Topic; D017286:Polysomnography / Q000191:economics / Q000523:psychology; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000191:economics* / Q000523:psychology / Q000628:therapy*; D012959:Socioeconomic Factors