Partner Involvement Associated With Baseline PAP Usage in Obstructive Sleep Apnea

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Abstract Introduction In obstructive sleep apnea (OSA), romantic partners can play an important role in adopting PAP (positive airway pressure) therapy, which has been shown to improve sleep and daytime functioning in both PAP users and their partners. However, understanding the drivers of partner involvement in real-world PAP therapy adoption remains a topic of exploration. Methods PAP therapy users with OSA (ResMed, San Diego) were invited to complete a one-time e-survey regarding their PAP therapy experience, including partner involvement in therapy management. Survey responses were retrospectively paired with device-captured therapy data to explore how partner involvement may change based on baseline PAP usage. Logistic regressions explored the association between gender (male/female) and average baseline PAP use (defined as < 4 hours/night, 4 to < 6 hours/night, and 6+ hours/night during the first 30 days of PAP initiation), with the odds of partnership involvement (partner monitor PAP usage (yes/no)). The model adjusted for self-reported age, baseline apnea hypopnea index (AHI), time on platform, and device mode. Results 8,893 PAP users were assessed. Median age was 59 years, and 40.1% were female. Median (IQR) baseline AHI was 15 (4.7, 33.4) and median (IQR) baseline PAP usage was 6.7 (5.4, 7.7) hours/night. Compared to users with ≥ 6 hours/night of PAP use, users who used their PAP device for 4 to <6 hours/night had a 58% greater likelihood of having a partner monitor their PAP usage (1.58 (1.43, 1.75); p < 0.001). Users who used their PAP device for <4 hours/night were almost twice as likely to have a partner monitor their PAP usage (1.96 (1.70, 2.27); p < 0.001). Compared to female users, male users were 45% more likely to have their partner monitor their PAP usage (1.45 (1.32, 1.58); p < 0.001). Conclusion Lower baseline PAP use was associated with increased odds of having a partner involved in therapy management, with males more likely to have their partner monitor usage compared to females. Tailoring social support interventions intended to promote PAP therapy might consider the role of baseline usage and gender. Future studies might further explore relationship dynamics such as trust and intimacy to further contextualize the findings observed.

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