The association between behavioral clusters and short-term PAP usage in OSA

<bold>Introduction:</bold> Early adoption of positive airway pressure (PAP) therapy is associated with long-term adherence in obstructive sleep apnea (OSA). Few studies have explored how clusters of behavioral determinants may impact PAP usage in OSA. <bold>Methods:</bold> New PAP therapy users enrolled in a digital therapy companion (myAir, ResMed) completed an emailed survey asking about their PAP experience and behavioral characteristics. Guided by the Social Cognitive Theory, we examined survey responses to identify behavioral clusters of self-efficacy (SE), motivation (M) and social support from a healthcare provider (SS), and then assessed their association with 90-day PAP usage (defined as > 4hrs/night on 70% of nights for 30 consecutive days). Clusters were developed using Ward’s Hierarchical Agglomerative Clustering applied on the dissimilarity matrix created by Gower Distance. Logistic regressions assessed the association, adjusting for marital status, gender, self-reported baseline BMI and AHI, current device mode, mask type, first week of usage, and setup date. <bold>Results:</bold> 2,494 respondents (50% female, mean age: 56 yrs, 48% mod-severe AHI) were assigned to three distinct clusters. See Table for results. <bold>Conclusion:</bold> Behavioral interventions fostering self-efficacy and motivation for PAP therapy may further promote compliance among new users. Additional investigation is needed to determine the timing and frequency of social support to maximize benefit. <fig><object-id>erj;64/suppl_68/PA3234/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>