Abstract

Obstructive sleep apnea syndrome is an increasingly recognized global epidemic [1]. Uninsured patients frequently lack access to specialized testing, treatment and specialists access. Such patients may have conflicting priorities that affect their ability to comply with sleep apnea therapy. Carolinas Sleep Services has an Ambulatory Sleep program in which uninsured patients in Mecklenberg County, NC are provided both diagnostic and treatment options at either no or minimal charge. We retrospectively reviewed the chart data for 236 patients at the Carolina Sleep Services Ambulatory Clinic to assess patient adherence to PAP therapy in this low-income population. 149 (63%) of the 236 patients were recommended to have positive airway pressure therapy; the remaining 87 patients were not recommended PAP therapies. Compliance reports were obtained for only 30 of the 149 patients; patients were not given CPAP devices with modems and the return of card data was a challenge. Of those with compliance reports, 14 (47%) were compliant with their therapy. However, since this study had severe limitations, further research into methods for improving therapeutic compliance in uninsured or low-income populations is suggested. Approaches for addressing PAP compliance in underserved populations may also be linked to broader issues of access to healthcare in this population.

Keywords: Compliance, positive airway pressure therapy, underserved population, obstructive sleep apnea syndrome, sleep disorder