Prevalence and predictors of positive airway pressure therapy prescription in obstructive sleep apnoea: a population-representative study

Background Obstructive sleep apnoea (OSA) is a common condition that is associated with several important comorbidities and increased mortality. Positive airway pressure (PAP) is an effective treatment for OSA that is associated with a reduction in mortality. This study investigated the prevalence and predictors of PAP prescription for OSA in Germany. Methods This retrospective observational study used an anonymized German claims research database. Adults (age ≥ 18 years) with treatment-naïve OSA who were or were not started on PAP were included. Results Of 22,317 participants, 12,297 (55%) were started on PAP; the remaining 10,020 individuals (45%) formed the control group (no PAP). Significant predictors of PAP prescription in multivariate logistic regression analysis were overweight/obesity, hypertension, heart failure, other cardiovascular diseases, gastro-oesophageal reflux disease, breathing abnormalities, vasomotor and allergic rhinitis, somatoform disorders and use of several medication classes (especially angiotensin receptor blockers, inhaled adrenergics or other inhaled drugs). Conclusion Only just over half of all individuals with OSA in the current analysis were prescribed PAP. The presence of a variety of comorbidities and use of several medication classes were significant predictors of PAP prescription. Future research should focus on identifying ways to increase PAP use in eligible individuals to optimize clinical outcomes.