P003 Effect of ethnicity on positive airway pressure acceptance for obstructive sleep apnoea

Abstract Introduction Despite having a similar prevalence, OSA in patients of Chinese descent is driven more by anatomical factors compared to Caucasians. However, there is a dearth of evidence investigating the effect of ethnicity on acceptance and usage of positive airway pressure (PAP). This study investigated the PAP acceptance rate and predictors in an ethnically diverse population referred for PAP acclimatisation in a tertiary referral hospital. Methods A retrospective analysis of consecutive PAP acclimatisation trials between 2014-2020 was performed. Patient demographics, polysomnographic variables, and PAP trial variables were compared between groups. Multivariate stepwise logistic regression analyses were performed to identify predictors of PAP acceptance in each group. Results 543 PAP acclimatisation trials were included (10.7% Chinese patients). There were no differences in age, gender or AHI between groups, however the Chinese group had a lower BMI (p<0.001), and higher ESS (p<0.05). There was no difference between groups for average PAP use, residual AHI or PAP acceptance rate (86% vs 92%). Logistic regression analysis revealed that PSG AHI, residual AHI and average PAP usage were predictors of PAP acceptance in Caucasians (adjusted ORs 1.03, 0.90 and 1.01 respectively), but only residual AHI and PAP usage were predictors in Chinese patients (adjusted ORs 0.86, 1.01). Conclusion PAP acceptance was similar in Chinese and Caucasian patients, however severity of disease did not predict acceptance in Chinese patients. Future research should focus on determining if Chinese versus Caucasian ethnicity is an important contributing factor to clinical outcomes and therapeutic responses in OSA.