Novel Aspects of CPAP Treatment and Interventions to Improve CPAP Adherence

Weaver, Terri E.

doi:10.3390/jcm8122220

Cited by 62 publications

(41 citation statements)

References 34 publications

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“…These are the first data from a large prospective cohort of patients treated by CPAP, confirming a significant improvement in CPAP adherence during the COVID-19 lockdown. CPAP efficacy is often limited by nonadherence related to a lack of disease-related risk perception [2]. In our case, massive communication about COVID-19, described as a threat to the upper and lower airways, might have motivated patients to be more adherent so as to protect their airways and themselves from the disease, particularly poor adherents.…”

mentioning

confidence: 82%

Impact of COVID-19 lockdown on adherence to continuous positive airway pressure by obstructive sleep apnoea patients

2020

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The psychological effects of the coronavirus 2019 (COVID-19) lockdown and fear of aerosolisation made us think that adherence to continuous positive airway pressure (CPAP) treatment might be reduced and consequently the morbidity and mortality of vulnerable obstructive sleep apnoea (OSA) patients increased. We analysed the impact of the COVID-19 national lockdown in France on objective adherence to CPAP assessed by telemonitoring in a cohort of 7485 patients with OSA between 15 January 2019 and 15 April 2020 [1]. Comparing data from the pre-COVID-19 period (1 month before 15 March 2020, the date of the national lockdown announcement) to data post-lockdown, there was a 3.9% (p<0.001) increase in adherence from a mean value of 386 min per night pre-COVID-19 to 401 min per night during lockdown. These data were confirmed by comparing the CPAP adherence rate during the first month of lockdown (15 March 2020 to 15 April 2020) to CPAP adherence during the same time-period in 2019, with a 4.48% increase during lockdown (p<0.001). The proportion of very low adherers (<10 min of CPAP use per night) dropped by 18.5% (p<0.001) between the similar periods in 2019 and 2020.

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confidence: 82%

Impact of COVID-19 lockdown on adherence to continuous positive airway pressure by obstructive sleep apnoea patients

2020

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“…Furthermore, a recent review has highlighted the importance of having a partner involved as a member of the team, as long as a positive relationship exists. This can contribute to producing positive adherence outcomes [ 30 ]. While our study focused on the spouse, it is important to note that the influence of a person who can relate to the patient can extend beyond the spouse.…”

Section: Discussionmentioning

confidence: 99%

Multidimensional Evaluation of Continuous Positive Airway Pressure (CPAP) Treatment for Sleep Apnea in Different Clusters of Couples

Mendelson

Gentina

et al. 2020

JCM

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Continuous positive airway pressure (CPAP) is the most efficient treatment of obstructive sleep apnea (OSA). Little is known about the impact of spousal relationship profiles on CPAP adherence. We aimed to identify clusters of couples of OSA patients, and their association with CPAP adherence 120 days after CPAP initiation. In a multicenter prospective study, OSA patients recently prescribed CPAP were enrolled with their spouses. Data about spousal relationships were collected at inclusion and at day 120. Latent class analysis was performed to determine homogeneous groups of spousal relationships. The 290 participants were predominantly males (77%), median age was 53 years and interquartile range (IQR) 46–62, median body mass index (BMI) was 32 kg/m2 (IQR: 28.6–35.9) and median apnea–hypopnea index: 43 events per hour (IQR: 33–58). Three couple clusters were identified: (1) older retired couples, (2) young working couples, and (3) mature active couples. Patients in the older retired couples cluster presented the highest CPAP adherence (p < 0.01) independently of initial complaints, OSA severity, and degree of improvement under CPAP. In a large cohort of OSA patients in whom clusters of couples were determined, there was a significant difference in CPAP adherence at day-120 after CPAP initiation.

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“…Continuous positive airway pressure (CPAP) therapy is the most effective treatment for OSA [ 6 , 7 ]. CPAP therapy has been found to improve cognitive processing and daily functioning; reduce daytime sleepiness [ 8 ]; and reduce health care costs, physician visits, and work absences [ 5 ]. Despite the reported benefits of CPAP therapy in treating OSA, its effectiveness is reduced by less-than-optimal adherence/usage.…”

Section: Introductionmentioning

confidence: 99%

“…Up to 50% of patients who accept CPAP therapy fail to adhere to it [ 8 ]. Patients’ failure to adhere to CPAP therapy is a major factor limiting its potential benefits [ 6 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

A Tailored Motivational Messages Library for a Mobile Health Sleep Behavior Change Support System to Promote Continuous Positive Airway Pressure Use Among Patients With Obstructive Sleep Apnea: Development, Content Validation, and Testing

Alismail¹,

Olfman²

2020

JMIR Mhealth Uhealth

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Background Continuous positive airway pressure (CPAP) therapy is the most effective treatment for obstructive sleep apnea (OSA). Despite the reported benefits of CPAP therapy in treating OSA, its effectiveness is reduced by less-than-optimal adherence or use. Up to 50% of patients who accept CPAP therapy fail to adhere to it. As a lack of commitment to CPAP therapy is one of the most significant factors that hinder OSA treatment effectiveness, patient motivation and education are critical to help alleviate the problem of poor CPAP adherence or use. Objective This study aims to support the development of mobile health interventions or information systems solutions to promote CPAP adherence and use among patients with OSA through development, content validation, and testing of tailored motivational messages. Methods In phase 1, an initial library of 60 messages was developed to promote CPAP use among patients with OSA. In phase 2, draft messages were evaluated for content validation testing for relevance and clarity by research and clinical experts. In phase 3, patients with OSA (N=24) were recruited through a Qualtrics panel to rate the perceived persuasiveness of the messages in terms of threat and efficacy perceptions, as per their computed extended parallel process model (EPPM) response states. The average score of the ratings was calculated for each message. The messages were sorted according to their average (from highest to lowest) to select the best 12 messages for each tailored set based on the potential responses from the EPPM. Results In phase 1, 60 messages were developed based on the existing literature and a review of existing materials. In phase 2, the enumerated content validity of the messages was established through the use of the content validity index for items. A total of 57 messages were found to have acceptable content relevance and clarity. In phase 3, patients with OSA perceived the final library of 48 messages to be persuasive. Conclusions After the process of content validation and testing, the final library of messages met the criteria for clarity, relevance, and perceived persuasiveness. This study emphasizes the importance of developing and validating the content of motivational messages, grounded in EPPM theory, across the 4 possible response states in terms of high or low efficacy and threat perceptions.

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Novel Aspects of CPAP Treatment and Interventions to Improve CPAP Adherence

Cited by 62 publications

References 34 publications

Impact of COVID-19 lockdown on adherence to continuous positive airway pressure by obstructive sleep apnoea patients

Impact of COVID-19 lockdown on adherence to continuous positive airway pressure by obstructive sleep apnoea patients

Multidimensional Evaluation of Continuous Positive Airway Pressure (CPAP) Treatment for Sleep Apnea in Different Clusters of Couples

A Tailored Motivational Messages Library for a Mobile Health Sleep Behavior Change Support System to Promote Continuous Positive Airway Pressure Use Among Patients With Obstructive Sleep Apnea: Development, Content Validation, and Testing

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