{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:49:24Z","timestamp":1791535764950,"version":"4.3.4"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,6,23]],"date-time":"2020-06-23T00:00:00Z","timestamp":1592870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100013981","name":"AASM Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013981","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"Department of Defense","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017647","name":"ResMed","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017647","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["K01HS024560"],"award-info":[{"award-number":["K01HS024560"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Study Objectives<\/jats:title>\n                  <jats:p>To examine rates of adherence to continuous positive airway pressure (CPAP) therapy among a representative sample of older adult Medicare beneficiaries with obstructive sleep apnea (OSA), and to identify demographic and health-related factors associated with CPAP adherence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using a 5% sample of Medicare claims data, we utilized Medicare policy and CPAP machine charges as a proxy for CPAP adherence. A cumulative logit model was used to identify demographic, medical, and psychiatric predictors of CPAP adherence status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of beneficiaries who initiated CPAP (n = 3,229), 74.9% (n = 2,417) met the so-called \u201c90-day Medicare adherence criteria,\u201d but only 58.8% of these individuals (n = 1,420) continued to use CPAP throughout the entire 13-month rent-to-own period. Anxiety, anemia, fibromyalgia, traumatic brain injury, and lower socioeconomic status (SES) were all associated with reduced CPAP adherence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These results provide the first national estimates of CPAP adherence among older adult Medicare beneficiaries in the United States. In addition, findings highlight the salience of medical and psychiatric comorbidity, as well as SES, as important markers of CPAP adherence among older adults in the United States. Future studies should seek to evaluate interventions to improve CPAP adherence among older adults of lower SES.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/sleep\/zsaa122","type":"journal-article","created":{"date-parts":[[2020,6,23]],"date-time":"2020-06-23T23:03:40Z","timestamp":1592953420000},"source":"Crossref","is-referenced-by-count":45,"title":["Lower socioeconomic status and co-morbid conditions are associated with reduced continuous positive airway pressure adherence among older adult medicare beneficiaries with obstructive sleep apnea"],"prefix":"10.1093","volume":"43","author":[{"given":"Emerson M","family":"Wickwire","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD"},{"name":"Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia L","family":"Jobe","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liesl M","family":"Oldstone","sequence":"additional","affiliation":[{"name":"ResMed, San Diego, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M","family":"Scharf","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abree M","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S","family":"Albrecht","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,6,23]]},"reference":[{"issue":"9","key":"2021062300101715400_CIT0001","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1016\/j.jacc.2010.04.032","article-title":"Under-diagnosis of sleep apnea in patients after acute myocardial infarction","volume":"56","author":"Konecny","year":"2010","journal-title":"J Am Coll Cardiol."},{"issue":"8","key":"2021062300101715400_CIT0002","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1164\/rccm.200509-1442OC","article-title":"Association of nocturnal arrhythmias with sleep-disordered breathing: the Sleep Heart Health 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