Claustrophobic tendencies and continuous positive airway pressure therapy non-adherence in adults with obstructive sleep apnea

(1) Determine claustrophobia frequency in adults with obstructive sleep apnea (OSA) after first CPAP night; (2) determine if claustrophobia influences CPAP non-adherence. Background: Claustrophobia is common among CPAP-treated OSA adults yet few studies have examined the problem. Methods: Secondary analysis of prospective, longitudinal study of OSA adults (n=97). CPAP-Adapted Fear and Avoidance Scale (CPAP-FAAS) collected immediately after CPAP titration polysomnogram. Primary outcome: objective CPAP use at 1week and 1month. Results: Sixty-three percent had claustrophobic tendencies. Females had higher CPAP-FAAS scores than males. FAAS ≥25, positive score for claustrophobic tendencies, was influential on CPAP non-adherence at 1week (aOR= 5.53, 95% CI 1.04, 29.24, p=0.04) and less CPAP use at 1month (aOR=5.06, 95% CI 1.48, 17.37, p = 0.01) when adjusted for body mass index and CPAP mask style. Conclusion: Claustrophobia is prevalent among CPAP-treated OSA adults and influences short-term and longer-term CPAP non-adherence. Interventions are needed to address this treatment-related barrier.