STUDY OBJECTIVE: To improve adherence to continuous positive airway pressure (CPAP) treatment in participants with obstructive sleep apnea (OSA) using a cognitive behavioral therapy (CBT) intervention. DESIGN: A randomized controlled trial. SETTING:A major teaching hospital in Sydney (2005). PARTICIPANTS: One hundred individuals (96 men), ranging in age from 32 to 81 years, diagnosed with OSA. INTERVENTION: Two 1-hour CBT interventions (including a video of real CPAP users) plus treatment as usual (mask fitting and information) or treatment as usual only. MEASUREMENTS AND RESULTS: Hours of CPAP usage was assessed at 7 nights and 28 nights. Adherence was defined as usage at least 4 hours per night. Questionnaires measuring self-efficacy, social support, and expectancy (mediators of adherence) were given after intervention or after usual treatment. A higher adherence to CPAP therapy was found in the CBT group (2.9 hours difference) relative to treatment as usual (P < 0.001) at 28 days. Only 4 participants in the CBT group did not initiate treatments after their titration study, compared with 15 in the treatment as usual group (P < 0.02). The CBT group had significantly higher scores for self-efficacy (P < 0.001) and social support P < 0.008) but not for expectancy. CONCLUSIONS: The CBT intervention resulted in both increased adherence and "uptake" of CPAP and therefore would be expected to reduce the social, economic, and health-related consequences of untreated OSA.
RCT Entities:
STUDY OBJECTIVE: To improve adherence to continuous positive airway pressure (CPAP) treatment in participants with obstructive sleep apnea (OSA) using a cognitive behavioral therapy (CBT) intervention. DESIGN: A randomized controlled trial. SETTING: A major teaching hospital in Sydney (2005). PARTICIPANTS: One hundred individuals (96 men), ranging in age from 32 to 81 years, diagnosed with OSA. INTERVENTION: Two 1-hour CBT interventions (including a video of real CPAP users) plus treatment as usual (mask fitting and information) or treatment as usual only. MEASUREMENTS AND RESULTS: Hours of CPAP usage was assessed at 7 nights and 28 nights. Adherence was defined as usage at least 4 hours per night. Questionnaires measuring self-efficacy, social support, and expectancy (mediators of adherence) were given after intervention or after usual treatment. A higher adherence to CPAP therapy was found in the CBT group (2.9 hours difference) relative to treatment as usual (P < 0.001) at 28 days. Only 4 participants in the CBT group did not initiate treatments after their titration study, compared with 15 in the treatment as usual group (P < 0.02). The CBT group had significantly higher scores for self-efficacy (P < 0.001) and social support P < 0.008) but not for expectancy. CONCLUSIONS: The CBT intervention resulted in both increased adherence and "uptake" of CPAP and therefore would be expected to reduce the social, economic, and health-related consequences of untreated OSA.
Authors: Delwyn Bartlett; Keith Wong; Dianne Richards; Emma Moy; Colin A Espie; Peter A Cistulli; Ronald Grunstein Journal: Sleep Date: 2013-11-01 Impact factor: 5.849
Authors: Nancy J Carballo; Cathy A Alessi; Jennifer L Martin; Michael N Mitchell; Ron D Hays; Nananda Col; Emily S Patterson; Stella Jouldjian; Karen Josephson; Constance H Fung Journal: Clin Ther Date: 2016-10-15 Impact factor: 3.393
Authors: Manya Somiah; Zachary Taxin; Joseph Keating; Anne M Mooney; Robert G Norman; David M Rapoport; Indu Ayappa Journal: J Clin Sleep Med Date: 2012-10-15 Impact factor: 4.062