Observational studyJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2018
Untreated Sleep Apnea: An Analysis of Administrative Data to Identify Risk Factors for Early Nonadherence.
Observational study in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The trial behind it
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Who cites it
6 citing papers in PubMed.
- Trial
- Predicting sleep apnea worsening and cardiometabolic risk without treatment.Sleep & breathing = Schlaf & Atmung · 2026Article
- Illness perceptions of obstructive sleep apnea (OSA) and intention of performing clinical diagnostic examination for OSA in Chinese older adults.BMC public health · 2025Article
- Use and limitations of databases and big data in sleep-disordered breathing research.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Adherence to prescribed overnight sleep study in patients suspected of sleep apnea: problem size and influential factors.Sleep & breathing = Schlaf & Atmung · 2021Article
- The PAP-NAP one decade later: patient risk factors, indications, and clinically relevant emotional and motivational influences on PAP use.Sleep & breathing = Schlaf & Atmung · 2020Article
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Authors and funding
5 authors.
Funding
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Abstract
STUDY
objectivesDiscontinuation of positive airway pressure (PAP) treatment for obstructive sleep apnea (OSA) is widely reported, but research has not adequately addressed nonadherence with diagnostic testing for sleep disorders and initiation of PAP. This study sought to identify drivers of nonadherence with diagnostic sleep testing and PAP treatment initiation among patients preauthorized for these services.
methodsThis observational cohort study used preauthorization records from a sleep management program and administrative medical claims from a large commercial health insurer. Participants included adults preauthorized for sleep testing and a subset in whom OSA was diagnosed and who were preauthorized for PAP treatment. Outcome measures were nonadherence with diagnostic sleep testing and PAP treatment initiation, identified as lack of a claim for a preauthorized service within 3 months of preauthorization of that service. Risk factors for nonadherence included patient demographics, prescribing factors, signs and symptoms of OSA, comorbidities, and prior health service utilization.
resultsOf 51,749 patients preauthorized for diagnostic testing, 23.5% did not undergo testing. Among 19,968 patients preauthorized for PAP treatment, 11.1% did not initiate treatment. Testing and treatment ordered by primary care providers, residence outside the Midwest region, and two or fewer office visits within 6 months before preauthorization were strong predictors of nonadherence. Apnea-hypopnea index score < 30 events/h was also a strong predictor of nonadherence with treatment initiation.
conclusionsThis study adds to existing knowledge about risk factors for nonadherence with sleep testing and treatment initiation following preauthorization. Health plans and providers should develop strategies to better engage patients with higher risk of nonadherence.
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