Download Full Text (673 KB)


Sleep Medicine

Training Level



Henry Ford Hospital


TITLE: Use of simplified claustrophobia questionnaire in predicting adherence to continuous positive airway pressure (CPAP) in obstructive sleep apnea (OSA) patients. Introduction: Claustrophobia could affect adherence to CPAP in sleep apnea patients. High score in a claustrophobia questionnaire containing 12 restriction and 14 suffocation items was associated to poor CPAP adherence in previous research. The restriction and suffocation items were equivalent on predicting CPAP adherence which allowed to limit the survey to only the suffocation questionnaire. The goal of this study is to find the predictability of CPAP adherence for each question of the suffocation questionnaire. Methods: We performed a prospective chart review of 114 patients with newly diagnosed OSA using home sleep apnea testing (HSAT). On initial consultation, patients were provided with a suffocation claustrophobia questionnaire. Patients’ demographics, home sleep study data and objective adherence data were collected within the first 3 months of usage.Results: Items 2 (OR =1.67, p-value = 0.049), 3 (OR=1.60, p-value = 0.021), and 13 (OR= 1.52, p-value = 0.056) are most promising in association with non-adherence. Results indicate that higher scores on item 2 is associated with higher odds of non-adherence to CPAP. Specifically, each point increase on item 2 was associated with a 67% increase in odds of non-adherence. However, these items alone do not show a large effect in providing accurate classification of adherence. Of these items, item 3 had the lower rate of missing data, suggesting that it may be the most patient-friendly item. Conclusions: Based on these results, the 3 questions with highest predictability for CPAP adherence will be studied in the clinical arena to address feasibility and predictability.

Publication Date


Use of simplified claustrophobia questionnaire in predicting adherence to positive airway pressure (PAP) therapy in obstructive sleep apnea (OSA) patients