Joseph M Dzierzewski1,2, Douglas M Wallace3,4, William K Wohlgemuth3. 1. David Geffen School of Medicine, University of California, Los Angeles, CA. 2. Geriatric Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, North Hills, CA. 3. Department of Neurology, Sleep Medicine Division, University of Miami Miller School of Medicine, Miami, FL. 4. Neurology Service, Bruce W. Carter VA Medical Center, Miami, FL.
Abstract
STUDY OBJECTIVES: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common sleep disorder associated with a myriad of sequelae. OSAHS is effectively treated with continuous positive airway pressure (CPAP) therapy. However, fewer than 50% of patients are compliant with their CPAP therapy prescriptions. The current study sought to explore an integrated, biopsychological approach to CPAP adherence among experienced CPAP users. METHODS: We performed a retrospective, cross-sectional analysis of a cohort of veterans with a diagnosis of OSAHS (n = 191) who were prescribed CPAP therapy and returned for adherence download at the Miami VA Sleep Clinic. The relationships between biomedical characteristics (e.g., CPAP pressure, self-reported sleepiness, and change in sleep efficiency) and psychological factors (e.g., self-efficacy beliefs and psychological diagnoses) and objectively measured CPAP use were examined to determine whether psychological factors moderated the relationships between biomedical characteristics and CPAP adherence. RESULTS: Hierarchical regression analyses predicting CPAP adherence (adjusting for time since CPAP prescription, age, education, prescribed CPAP pressure, daytime sleepiness, changes in sleep efficiency with CPAP, and psychiatric conditions) revealed the following: (1) CPAP self-efficacy and CPAP pressure were positively related to adherence, and (2) CPAP self-efficacy moderates the relationship between CPAP pressure and CPAP adherence. CONCLUSIONS: There was no relationship between CPAP pressure and adherence in individuals with low self-efficacy beliefs. However, for individuals with high self-efficacy beliefs, there was a significant positive relationship between CPAP pressure and adherence. Self-efficacy beliefs appear to be a prime target for focused interventions aimed at improving CPAP adherence among those individuals with higher pressure prescriptions.
STUDY OBJECTIVES: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common sleep disorder associated with a myriad of sequelae. OSAHS is effectively treated with continuous positive airway pressure (CPAP) therapy. However, fewer than 50% of patients are compliant with their CPAP therapy prescriptions. The current study sought to explore an integrated, biopsychological approach to CPAP adherence among experienced CPAP users. METHODS: We performed a retrospective, cross-sectional analysis of a cohort of veterans with a diagnosis of OSAHS (n = 191) who were prescribed CPAP therapy and returned for adherence download at the Miami VA Sleep Clinic. The relationships between biomedical characteristics (e.g., CPAP pressure, self-reported sleepiness, and change in sleep efficiency) and psychological factors (e.g., self-efficacy beliefs and psychological diagnoses) and objectively measured CPAP use were examined to determine whether psychological factors moderated the relationships between biomedical characteristics and CPAP adherence. RESULTS: Hierarchical regression analyses predicting CPAP adherence (adjusting for time since CPAP prescription, age, education, prescribed CPAP pressure, daytime sleepiness, changes in sleep efficiency with CPAP, and psychiatric conditions) revealed the following: (1) CPAP self-efficacy and CPAP pressure were positively related to adherence, and (2) CPAP self-efficacy moderates the relationship between CPAP pressure and CPAP adherence. CONCLUSIONS: There was no relationship between CPAP pressure and adherence in individuals with low self-efficacy beliefs. However, for individuals with high self-efficacy beliefs, there was a significant positive relationship between CPAP pressure and adherence. Self-efficacy beliefs appear to be a prime target for focused interventions aimed at improving CPAP adherence among those individuals with higher pressure prescriptions.
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: Jason C Ong; Megan R Crawford; Spencer C Dawson; Louis F Fogg; Arlener D Turner; James K Wyatt; Maria I Crisostomo; Bantu S Chhangani; Clete A Kushida; Jack D Edinger; Sabra M Abbott; Roneil G Malkani; Hrayr P Attarian; Phyllis C Zee Journal: Sleep Date: 2020-09-14 Impact factor: 5.849
Authors: Sharn Rowland; Vinod Aiyappan; Cathy Hennessy; Peter Catcheside; Ching Li Chai-Coezter; R Doug McEvoy; Nick A Antic Journal: J Clin Sleep Med Date: 2018-01-15 Impact factor: 4.062