Development and Validation of a Nomogram for Predicting Non-Adherence to Continuous Positive Airway Pressure Therapy in Patients with Obstructive Sleep Apnea.

BACKGROUND

Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea (OSA), but its long-term efficacy is limited by poor patient adherence. This study aimed to develop and validate a predictive nomogram for CPAP non-adherence in patients with OSA.

METHODS

This is a secondary analysis of a retrospective study. A cohort of 695 Danish patients with OSA were followed for 3 years after initiating CPAP therapy. Independently associated factors were evaluated using multivariate Cox regression, and then nomogram predicting adherence to CPAP use were constructed. The discrimination of the nomogram was assessed using receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA).

RESULTS

Pulmonary disease, oxygen desaturation index (ODI), Epworth Sleepiness Score (ESS) and severity of OSA were identified as predictors and incorporated into the nomogram. The nomogram demonstrated good discrimination with concordance index in training dataset (0.73, 95% CI: 0.69-0.78) and validation dataset (0.72, 95% CI: 0.66-0.79). ROC curve, calibration curve, and DCA indicated the nomogram had good clinical utility.

CONCLUSION

This study provided an effective nomogram for predicting CPAP non-adherence in OSA patients.