1201 OSA Treatment Engagement: Examining the Impact of Split-Night PSG Review on CPAP Adherence Among Veterans

Abstract Introduction Obstructive sleep apnea (OSA) disproportionately affects Veterans compared to the average American . This is due to a higher incidence of comorbidities such as PTSD, history of TBI and occupational exposures. Split-night polysomnography (PSG) is a cost-effective tool that is indicated for the diagnosis of OSA in select populations and can accomplish faster time to treatment than the gold standard two-night PSG . Unfortunately, CPAP adherence among Veterans remains low. This review aims to evaluate patient adherence to continuous positive airway pressure (CPAP) therapy following a patient-centered review of split-night PSG. Methods A prospective observational study was performed at the VA Hospital in Brooklyn, NY on patients undergoing a split-night PSG vs traditional two-night PSG. All patients received a standardized review of their own PSG measurements. Compliance reports were then followed for 90 days. CPAP adherence metrics were reviewed at 30 and 90 days after counseling. Adherence outcomes were compared before and after split-night review. Results Veterans who received PSG review and counseling were more likely to seek out assistance with CPAP material and supply issues, although adherence rates did not improve significantly after counseling. Conclusion Veterans who received split-night PSG counseling did not demonstrate improved CPAP adherence. While the split-night review approach appeared to correlate with more incentive for treatment, it did not translate to higher adherence. Despite efficiency, strategies beyond counseling may be necessary to improve long term adherence in a high-risk population. Support (if any)