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Limited data suggest racial disparities in continuous positive airway pressure (CPAP) adherence exist. To assess if CPAP adherence varies by neighborhood racial composition at a national scale. Telemonitoring data from a CPAP manufacturer database were used to assess adherence in adult patients initiating CPAP therapy between November 2015 and October 2018. Mapping zip code to zip code tabulation areas (ZCTAs), age- and gender- adjusted CPAP adherence data at a neighborhood level was computed as a function of neighborhood racial composi