Positive Airway Pressure (PAP) Use in Obstructive Sleep Apnoea (OSA) Patients with and without Insomnia
Bibliographic record
Abstract
Rationale: OSA is a common sleep disorder with growing prevalence. The comorbid association between OSA and insomnia (COMISA) is frequent and may make adhering to PAP therapy more difficult. This study aimed to analyse real-world data on PAP therapy usage for 2 years in patients with COMISA or OSA. Methods: Objective PAP therapy usage data were linked to de-identified US claims data. Patients with COMISA were defined by an OSA diagnosis with either an insomnia diagnosis or medication fill in both the year prior to and in the 2 years post starting PAP (index). Patients with only OSA were defined by the absence of insomnia in the year prior to nor 2 years post index. PAP discontinuation was defined as >30 continuous days with no PAP use. Results: Compared to patients with OSA (176,449), patients with COMISA (27,071) had a higher comorbidity burden, namely in affective disorders (depression: 40.8% vs 16.6%; anxiety 39.3% vs 16.3%), and were more commonly female (53.0% vs 37.6%). PAP therapy usage was lower and PAP therapy discontinuation rates were higher in patients with COMISA than OSA (Figure). For those who stayed on therapy, average usage in patients with COMISA and OSA was similar. Conclusion: Patients with COMISA discontinue therapy at higher rates than patients with OSA without insomnia. Clinicians should recognise that patients with COMISA may require additional support in adhering to PAP therapy. erj;64/suppl_68/PA3542/F1 F1 F1
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".