Effect of Personality Trait for PAP Therapy Adherence in OSA Patients

Abstract

PURPOSE: Positive Airway Pressure (PAP) therapy is the most common modality of treatment for obstructive sleep apnea (OSA) but adherence remains a significant problem. Personality traits may be some of the most important factors for non-adherence. Aim of this study to find the relationship between adherence and patient personality traits. METHODS: This was a cross sectional prospective clinical study. Patients were recruited during their visit in sleep clinic. Their personal characteristics, Polysomnography (PSG) results were collected from the electronic chart. Behavioral inhibition system/ behavioral activation system (BIS/BAS) scales, short measure of five factor model personality traits (mini-IPIP), Positive and Negative Affect Score (PANAS) tests were used for personality trait measurement. Data from the PAP device was obtained to measure adherence. Pearson correlation, T-test, Kruskal-Wallis test, Chi-square test or Fisher's exact test were used in the univariate analyses. Logistic regression was used in the multivariate analyses. RESULTS: A total 400 patients were recruited. 77 cases were excluded from the study due to incomplete data. Two patients withdrew from the study. As a result, 321 patients had all data for evaluation. Most of them (307) were male and only 14 were female. The mean age was 60.6 years with a standard deviation of 12.7. Among the 321 evaluated patients, 160 were classified as compliant. In the univariate analyses, older age (>65), profession, PAP type, side effect, efficiency and Behavioral Activation System Fun Seeking (BAS FS), BMI, Apnea-Hypopnea Index (AHI) were significantly associated with PAP adherence. A multivariate analysis revealed that profession, PAP type, efficiency, age, BAS FS are still significant predictors after adjusting for other covariates. A further analysis with total usage time and days without usage also showed significant association with adherence for Intellect Imagination and Negative Affect respectively by Pearson correlation.