title: Attempters, adherers, and non-adherers: latent profile analysis of CPAP use with correlates.
abstract: OBJECTIVE
  To examine whether subtypes of continuous positive airway pressure (CPAP) user profiles could be identified, and to determine predictors of CPAP subgroup membership.
  
  
  METHODS
  A 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.
  
  
  METHODS
  Miami VA Sleep Clinic.
  
  
  METHODS
  Obstructive sleep apnea patients (N = 207).
  
  
  METHODS
  Three 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.
  
  
  RESULTS
  Latent 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.
  
  
  CONCLUSIONS
  Sixty-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.
authors.affiliation: Sleep Disorders Center, Bruce W. Carter VA Medical Center, Miami, FL, USA. Electronic address: william.wohlgemuth@va.gov.
authors.forename: William K
authors.initials: WK
authors.lastname: Wohlgemuth
authors.affiliation: Psychology, University of Miami, Coral Gables, FL, USA.
authors.forename: Diana A
authors.initials: DA
authors.lastname: Chirinos
authors.affiliation: Psychology, Nova Southeastern University, Ft Lauderdale, FL, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Domingo
authors.affiliation: Sleep Disorders Center, Bruce W. Carter VA Medical Center, Miami, FL, USA; Neurology, University of Miami, Miami, FL, USA.
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Wallace
mesh_terms: D000368:Aged; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance; D012189:Retrospective Studies; D012307:Risk Factors; D020377:Self Efficacy; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D011795:Surveys and Questionnaires; D014728:Veterans
keywords: Adherence; Continuous positive airway pressure; Latent profile analysis; Obstructive sleep apnea; Veterans