0791 Perceived racial discrimination predicts poor PAP adherence: a pilot study

Abstract

Abstract Introduction Although racial and ethnic differences in continuous positive airway pressure (CPAP) adherence for people with obstructive sleep apnea (OSA) are well known, no studies have examined the influence of racial discrimination on CPAP use. The aim of this study was to determine if racial discrimination influenced CPAP use trajectories. Methods Participants with OSA initiating CPAP were enrolled from two sleep centers in New York City. Participants completed questionnaires including sociodemographics, perceived discrimination, daytime sleepiness, and depressive symptoms. Racial discrimination was measured via the validated Everyday Discrimination scale (EDS) , Participants endorsed at least one discriminatory experience “at least once a year” and race was the main reason for this treatment. Sociodemographic and questionnaire comparison were performed between participants reporting the presence and absence of racial discrimination. To examine differences in the trajectory of CPAP use based on racial discrimination status (between-subjects factor), we performed a two-factor repeated measures ANOVA with mean hours of daily use at 7, 30 and 90 days serving as the time dependent variable (within-subjects factor). Analyses were adjusted for depressive symptoms. Results The sample consisted of 88 participants (40% female; 40% Non-Hispanic Black; mean age of 57 ± 14 yrs). Twenty-two individuals (25% of the cohort) reported racial discrimination. In unadjusted two-factor repeated measures ANOVA, the test statistic for equality of racial discrimination CPAP adherence means over time was highly significant [ F = 9.71 (1, 68); p = 0.003] while the test for interaction between racial discrimination and time was marginally significant [F = 3.19 (1.53, 103.8); p = 0.059). Main effects for time were significant for participants reporting discrimination (p=0.04) but not for those without racial discrimination experiences (p=0.25). Thus, people reporting racial discrimination experienced greater decrement in CPAP use over time while a more stable CPAP use pattern was observed in those not perceiving racial discrimination. Conclusion Racial discrimination status may determine future poor CPAP adherence. Larger studies examining mechanisms of how perceived racial discrimination mediates worse CPAP adherence may assist in mitigating CPAP adherence disparities. Support (If Any) Natasha Williams was supported by grant from the National Institutes of Health: K23125939