CPAP adherence is associated with reduced risk for stroke among older adult Medicare beneficiaries with obstructive sleep apnea

Emerson M. Wickwire, M. Doyinsola Bailey, Virend K. Somers, Mukta C. Srivastava, Steven M. Scharf, Abree M. Johnson, Jennifer S. Albrecht

Research output: Contribution to journalArticlepeer-review

Abstract

Study Objectives: To examine the impact of adherence to continuous positive airway pressure (CPAP) therapy on risk of stroke among a nationally representative sample of older adults with obstructive sleep apnea. Methods: We performed a retrospective cohort study among Medicare beneficiaries aged ≥ 65 years who were newly diagnosed with obstructive sleep apnea and had initiated CPAP (2009-2013). Monthly indicators of CPAP adherence included charges formachines, masks, or supplies and were summed over a 25-month follow-up to create a CPAP adherence variable. Stroke was modeled as a function of CPAP adherence using generalized estimating equations. Results:We found that 5,757 beneficiariesmet the inclusion criteriaandwere included inthe final sample.Of these, 407 (7%) experienced stroke. After adjusting for demographic and clinical characteristics, CPAP adherence was associated with a reduced risk of stroke (hazard ratio, 0.98; 95%confidence interval, 0.96-0.99) over 25 months, indicating a 2% reduction in risk of stroke for each month of CPAP adherence.When sensitivity analyses were performed to stratify results by time since the first CPAP charge, the protective effect remained significant for the 12- and 6-month but not the 3-month outcome models. Conclusions: In this national analysis of older adult Medicare beneficiaries with obstructive sleep apnea, CPAP adherence was associated with significantly reduced risk of stroke.

Original languageEnglish (US)
Pages (from-to)1249-1255
Number of pages7
JournalJournal of Clinical Sleep Medicine
Volume17
Issue number6
DOIs
StatePublished - Jun 1 2021

Keywords

  • Adherence
  • CPAP
  • Cardiovascular
  • Continuous positive airway pressure
  • Medicare
  • Obstructive sleep apnea
  • Older adults
  • Stroke
  • Treatment

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

Fingerprint

Dive into the research topics of 'CPAP adherence is associated with reduced risk for stroke among older adult Medicare beneficiaries with obstructive sleep apnea'. Together they form a unique fingerprint.

Cite this