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Introduction Continuous positive airway pressure (CPAP) treatment has a consistently low adherence rate, with approximately 35% of patients not tolerating it long term (Rotenberg, Murariu, Pang 2016). What if non-adherence rates are influenced by anatomical airway differences? What if we can identify these before the struggle with CPAP even begins? This study investigates whether CPAP compliance is statistically related to anatomical structures identified in drug induced sedation endoscopy (DISE) procedures in patients with sleep apnoea. The primary hypothesis is that there will be a significant relation between CPAP compliance and anatomical structures identified during DISE.Method Data from patients using standard ResMed Airsense 10 & 11 machines (n=59) were compared within group. All machines automatically titrated pressure. Participants with mild, moderate, and severe apnoea were included. Treatment efficacy was measured by AHI average over 365 days. Compliancy was measured by the percentage of days CPAP was used >= 4 hours out of days CPAP was used over the last 365 of data as well as minutes used on average per 12-hour session. DISE procedures were performed at UCLH by in-house surgeons. Structure features included palette collapse, tonsil size, lateral wall collapse, tongue base collapse, epiglottis trap door collapse, turbinate size, and septum position.Results PRELIMARY DATA RESULTS. One-way ANOVAs were performed to compare the effect DISE identified structures on CPAP pressures.A one-way ANOVA revealed that there was a statistically significant difference in mean CPAP adherence usage per night when measuring the degree of lateral wall collapse p < 0.05 (F(2, 56) = [3.23], p = [0.047]). One-way ANOVAs performed for other DISE identified structures did not reveal statistically significant differences in CPAP adherence.Post Hoc tests and Multi-way ANOVAs are to be performed for the final data presentation.Conclusions There was a clinically relevant significant correlation between CPAP adherence and lateral wall collapse when identified in a DISE procedure. Therefore, the null hypothesis can be rejected. Further investigation on internal airway structures during sleep apnoea is required to investigate to what degree airway structures influence comfort and compliance of CPAP therapy.