Sleep and Breathing

, Volume 17, Issue 1, pp 351–363 | Cite as

Determinants of continuous positive airway pressure adherence in a sleep clinic cohort of South Florida Hispanic veterans

  • D. M. WallaceEmail author
  • S. S. Vargas
  • S. J. Schwartz
  • M. S. Aloia
  • S. Shafazand
Original Article



There are little existing data on continuous positive airway pressure (CPAP) adherence in US Hispanic veterans with obstructive sleep apnea (OSA). Our aim was to describe determinants of 1-month adherence in a sleep clinic cohort of South Florida Hispanic veterans.


Hispanic veterans referred to the Miami VA sleep clinic were recruited and completed questionnaires about sleep apnea risk, sleep quality, insomnia symptoms, sleepiness, depression/anxiety, acculturation, personality traits, and cognitions about OSA and CPAP. Individuals at risk for OSA were scheduled for baseline polysomnography (PSG), followed by in-lab CPAP titration or a trial of auto-CPAP. Participants with OSA accepting CPAP therapy were asked to return after 7 and 30 days of treatment for adherence verification and to repeat questionnaires.


One hundred twenty-four participants (94 % men) were enrolled with 114 completing overnight PSG. Eighty-six out of 95 participants (91 %) with sleep apnea syndrome or moderate to severe OSA accepted CPAP treatment. Fifty-nine participants completed both follow-up visits with a mean CPAP use at 30 days of 3.6 ± 2.0 h. The only independent predictor of 7-day mean daily CPAP use was the baseline Insomnia Severity Index while the best predictor of 30-day mean daily CPAP use was the 7-day mean daily use.


Our study suggests that South Florida Hispanic veterans with OSA evaluated in a sleep clinic show poor CPAP adherence. Insomnia and poor early use predicted poor adherence overall. Larger prospective studies with other race–ethnic groups are needed to determine the role of ethnicity and race in CPAP adherence among US veterans with OSA.


Veterans Hispanics Continuous positive airway pressure Adherence Obstructive sleep apnea 



This material is based upon work performed at the Miami VA Healthcare System. Dr. Shafazand was supported by a grant from the American Sleep Medicine Foundation.

Conflict of interest

The authors have no conflicts of interests regarding the project described herein.


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • D. M. Wallace
    • 1
    • 2
    Email author
  • S. S. Vargas
    • 3
  • S. J. Schwartz
    • 4
  • M. S. Aloia
    • 5
  • S. Shafazand
    • 3
  1. 1.Department of Neurology, Sleep Medicine DivisionUniversity of Miami Miller School of MedicineMiamiUSA
  2. 2.Bruce W. Carter Department of Veterans Affairs Medical CenterNeurology ServiceMiamiUSA
  3. 3.Department of Medicine, Division of Pulmonary, Critical Care, and Sleep MedicineUniversity of Miami Miller School of MedicineMiamiUSA
  4. 4.Center for Family StudiesUniversity of Miami Miller School of MedicineMiamiUSA
  5. 5.Department of MedicineNational Jewish HealthDenverUSA

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