Positive Airway Pressure (PAP) Use in Obstructive Sleep Apnoea (OSA) Patients with and without Insomnia

<bold>Rationale:</bold> OSA is a common sleep disorder with growing prevalence. The comorbid association between OSA and insomnia (COMISA) is frequent and may make adhering to PAP therapy more difficult. This study aimed to analyse real-world data on PAP therapy usage for 2 years in patients with COMISA or OSA. <bold>Methods:</bold> Objective PAP therapy usage data were linked to de-identified US claims data. Patients with COMISA were defined by an OSA diagnosis with either an insomnia diagnosis or medication fill in both the year prior to and in the 2 years post starting PAP (index). Patients with only OSA were defined by the absence of insomnia in the year prior to nor 2 years post index. PAP discontinuation was defined as >30 continuous days with no PAP use. <bold>Results:</bold> Compared to patients with OSA (176,449), patients with COMISA (27,071) had a higher comorbidity burden, namely in affective disorders (depression: 40.8% vs 16.6%; anxiety 39.3% vs 16.3%), and were more commonly female (53.0% vs 37.6%). PAP therapy usage was lower and PAP therapy discontinuation rates were higher in patients with COMISA than OSA (<bold>Figure</bold>). For those who stayed on therapy, average usage in patients with COMISA and OSA was similar. <bold>Conclusion:</bold> Patients with COMISA discontinue therapy at higher rates than patients with OSA without insomnia. Clinicians should recognise that patients with COMISA may require additional support in adhering to PAP therapy. <fig><object-id>erj;64/suppl_68/PA3542/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>