STUDY OBJECTIVES To examine rates of adherence to continuous positive airway pressure (CPAP) therapy among a representative sample of older adult Medicare beneficiaries with obstructive sleep apnea (OSA), and to identify demographic and health-related factors associated with CPAP adherence. METHODS Using a 5% sample of Medicare claims data, we utilized Medicare policy and CPAP machine charges as a proxy for CPAP adherence. A cumulative logit model was used to identify demographic, medical, and psychiatric predictors of CPAP adherence status. RESULTS Of beneficiaries who initiated CPAP (n=3229), 74.9% (n=2417) met the so-called "90-day Medicare adherence criteria," but only 58.8% of these individuals (n=1420) continued to use CPAP throughout the entire 13-month rent-to-own period. Anxiety, anemia, fibromyalgia, traumatic brain injury, and lower socioeconomic status (SES) were all associated with reduced CPAP adherence. CONCLUSIONS These results provide the first national estimates of CPAP adherence among older adult Medicare beneficiaries in the United States. In addition, findings highlight the salience of medical and psychiatric comorbidity, as well as SES, as important markers of CPAP adherence among older adults in the US. Future studies should seek to evaluate interventions to improve CPAP adherence among older adults of lower SES.

中文翻译：

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在患有阻塞性睡眠呼吸暂停的老年医疗保险受益人中，较低的社会经济地位和合并症与 CPAP 依从性降低有关

研究目标旨在检查具有阻塞性睡眠呼吸暂停 (OSA) 的老年医疗保险受益人的代表性样本中持续气道正压通气 (CPAP) 治疗的依从性，并确定与 CPAP 依从性相关的人口统计学和健康相关因素。方法 使用 5% 的医疗保险索赔数据样本，我们利用医疗保险政策和 CPAP 机器费用作为 CPAP 依从性的代理。累积 logit 模型用于确定 CPAP 依从性状态的人口统计学、医学和精神病学预测因素。结果 在启动 CPAP 的受益人 (n=3229) 中，74.9% (n=2417) 符合所谓的“90 天医疗保险依从性标准”，但这些人中只有 58.8% (n=1420) 在整个过程中继续使用 CPAP整个 13 个月的自租期。焦虑、贫血、纤维肌痛、创伤性脑损伤、和较低的社会经济地位 (SES) 都与 CPAP 依从性降低有关。结论 这些结果提供了美国老年医疗保险受益人对 CPAP 依从性的首次全国估计。此外，研究结果强调了医学和精神共病以及 SES 作为美国老年人 CPAP 依从性的重要标志物的显着性。未来的研究应寻求评估干预措施，以提高 SES 较低的老年人对 CPAP 的依从性。作为美国老年人 CPAP 依从性的重要标志。未来的研究应寻求评估干预措施，以提高 SES 较低的老年人对 CPAP 的依从性。作为美国老年人 CPAP 依从性的重要标志。未来的研究应寻求评估干预措施，以提高 SES 较低的老年人对 CPAP 的依从性。