Relationship quality and CPAP adherence in patients with obstructive sleep apnea.

The prospective influence of relationship support and conflict on adherence to continuous positive airway pressure (CPAP) was examined over the first 3 months of CPAP treatment in 42 married, male patients with obstructive sleep apnea (OSA). CPAP adherence reports were available for 23 patients. Patient ratings of marital conflict predicted average nightly adherence (beta = -0.357, p < .05), but ratings of marital support did not predict adherence. Three-month follow-up ratings of marital support and conflict, subjective sleepiness, depression, and functional impairment were available for 16 patients from the first sample. Six additional patients without adherence reports provided baseline and 3-month follow-up questionnaire data, which resulted in a total of 22 patients with follow-up questionnaire data. Following 3 months of CPAP, patients reported decreased marital conflict (d = 0.43, p < .05), sleepiness (d = 1.13, p < .001), depression (d = 0.73, p < .001), and functional impairment (d = 1.48, p < .001). These findings highlight the importance of evaluating marital conflict for OSA patients and suggest marital conflict may be a target for interventions to improve CPAP adherence.