0545 THE RELATIONSHIP OF HYPOPNEA APNEA RATIO (HAR) TO EFFECTIVE POSITIVE AIRWAY PRESSURE FOR OBSTRUCTIVE SLEEP APNEA HYPOPNEA SYNDROME

Abstract Introduction Inadequate health literacy (HL) is associated with 1.5 - 3 times increased risk for poor health outcomes, nonadherence and lack of skills needed to manage one’s own health. Inadequate HL prevalence in adults with obstructive sleep apnea (OSA) may be as high as 30%. The relationship between HL and positive airway pressure (PAP) adherence has been rarely examined. Methods A secondary analysis of prospective observational data was conducted to: 1) examine the prevalence of inadequate HL in adults with newly-diagnosed OSA and 2) determine if inadequate HL is associated with 1-wk and 1-mo PAP use. HL was measured using a 3-item Health Literacy Screening Questionnaire. Descriptive statistics, multiple linear regression, and logistic regression were used. Results Participants (n=67) were white (85%), males (52%) and females (48%), middle-aged (50±12 yrs), 64.2% had a middle to high school education and severe OSA (mean AHI 38.2±21 events/hr). Mean PAP use was 4.62±2.43 hrs/night at 1-wk and 4.33±2.27hrs/night at 1-mo. Using a threshold of ≥4 hrs/night, 64% were adherent at 1-wk and 60% at 1-mo. Sixty two percent (n=42) screened positive for inadequate HL. A positive screen for inadequate HL (by individual screening items or by cumulative number of items screened positive) was not associated with PAP use (mean hr/night) at 1-wk or 1-mo (not retained in the final model). HL was also not associated with PAP non-adherence (<4hrs/night) or PAP failure (<2hrs/night) by logistic regression. Conclusion Inadequate HL may be prevalent in adults with OSA. OSA and PAP patient education content and design should align with HL abilities and skills. Disease and treatment education are influential on PAP adherence. Future research should consider adequacy of three generalized items to assess HL and disease-specific HL as more robust measures are available. Larger, heterogeneous sample sizes are needed to precisely estimate the relationship between HL and PAP adherence. Support Lead author receives support from NIH/NHLBI Award T32 HL07953.

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Obstructive Sleep Apnea in Heart Failure: Review of Prevalence, Treatment with Continuous Positive Airway Pressure, and Prognosis

Texas Heart Institute Journal ◽

10.14503/thij-15-5678 ◽

2018 ◽

Vol 45 (3) ◽

pp. 151-161 ◽

Cited By ~ 11

Author(s):

Himad K. Khattak ◽

Faisal Hayat ◽

Salpy V. Pamboukian ◽

Harvey S. Hahn ◽

Brian P. Schwartz ◽

...

Keyword(s):

Heart Failure ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Continuous Positive Airway Pressure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Preserved Ejection Fraction ◽

Obstructive Sleep ◽

Artery Disease ◽

The Relationship

Obstructive sleep apnea is a sleep-related breathing disorder that has a major impact on cardiovascular function. It has been associated with hypertension, coronary artery disease, cardiac arrhythmias, sudden cardiac death, and heart failure. This review focuses on the relationship between obstructive sleep apnea and heart failure with either reduced or preserved ejection fraction. We discuss the pathophysiology of obstructive sleep apnea, as well as its prevalence, treatment outcomes with continuous positive airway pressure, and prognosis in these 2 distinct types of heart failure. We also identify areas in which further work is needed to improve our understanding of this association in heart failure patients.

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