Spousal involvement in CPAP adherence among patients with obstructive sleep apnea

Baron, Kelly Glazer; Smith, Timothy W.; Berg, Cynthia A.; Czajkowski, Laura A.; Gunn, Heather E.; Jones, Christopher R.

doi:10.1007/s11325-010-0374-z

Cited by 74 publications

(68 citation statements)

References 73 publications

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“…Social factors such as socioeconomic status, social support, and partner involvement have been shown in some studies to affect adherence, although not in a simple manner. 42,45,53 Similarly, psychological factors have also been shown to predict adherence in many studies, [18][19][20] although not in all. 47,49 Most of the current literature focuses on the use of psychological interventions to promote CPAP usage (CBT, 54 motivational interviewing 55 ), but these are time and resource intensive, so that identifying who would or would not benefit from these interventions may be useful.…”

Section: 49mentioning

confidence: 99%

Sleep Quality, Short-Term and Long-Term CPAP Adherence

Somiah

Taxin

Keating

et al. 2012

Journal of Clinical Sleep Medicine

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S C I E N T I F I C I N V E S T I G A T I O N SU ntreated obstructive sleep apnea/hypopnea syndrome (OSAHS) signifi cantly affects quality of life and cardiovascular/cerebrovascular morbidities and mortality.1-4 CPAP therapy has been shown to be effective in treating sleep disordered breathing (SDB) by reducing the apnea/hypopnea index (AHI) 5 and by reducing excessive daytime somnolence (EDS). 6Despite this, CPAP acceptance and adherence are disappointingly low. A signifi cant number of patients (ranging from 30% to 80% in various studies) demonstrate an average CPAP usage of less than 4 hours per night. 7,8 Several reviews have emphasized the need to identify patients who are at the greatest risk for non-adherence, with the goal of developing techniques to maximize overall adherence. 9,10Studies have suggested that CPAP adherence can be correlated to characteristics of patients at baseline, such as the severity of OSAHS, 11-13 the level of EDS, 14 and anatomical factors (smaller nasal cross-sectional area, reduced nasal volume, and high nasal resistance 15,16 ), but the strength of these correlations has been weak. Drake et al. showed that patients whose sleep effi ciency on the CPAP titration night improved most had the greatest CPAP compliance at 47 days.17 More recently, studies using social cognitive theory 18-20 and health BRIEF SUMMARYCurrent knowledge/Study Rationale: Despite its efficacy, adherence to CPAP therapy is highly variable amongst patients with obstructive sleep apnea with large numbers of patients demonstrating inadequate adherence to CPAP. The present study is aimed at identifying early predictors of CPAP adherence from variables obtained at the time of diagnosis and titration of CPAP, thereby providing potential for early intervention. Study Impact: Our data show that better sleep quality (greater % REM) was seen in patients with higher CPAP adherence and confi rm that long term adherence was largely predicted by short term adherence. This suggests that interventions that improve sleep during or prior to the CPAP titration study may be useful in improving CPAP adherence.

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Section: 49mentioning

confidence: 99%

Sleep Quality, Short-Term and Long-Term CPAP Adherence

Somiah

Taxin

Keating

et al. 2012

Journal of Clinical Sleep Medicine

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“…The symptoms of OSA, including snoring, daytime sleepiness, and depressed mood, affect both patient and partner quality of life (Doherty et al 2003;Reishtein et al 2006;Cartwright 2008;Cartwright and Knight 1987;Baron et al 2009). In male participants, relationship conflict was associated with poorer adherence and collaborative involvement from the spouse was associated with higher adherence (Baron et al 2009(Baron et al , 2011. Results of this study cannot address gender differences per se; but, we can compare magnitude of correlations between studies.…”

Section: Discussionmentioning

confidence: 91%

“…It is possible that the women who did not provide responses to this question either did not experience unhelpful spousal involvement or were reluctant to report it. Our previous study of spousal involvement in men utilized a written survey and found that 57% of male patients reported their spouse attempted to scare them into using CPAP, which is typically viewed as a negative tactic (Baron et al 2011).…”

Section: Discussionmentioning

confidence: 99%

“…However, these studies did not take into account relationship quality or they ways in which spouses were involved. We previously reported in a study of male patients with OSA, higher relationship conflict was associated with poorer adherence and collaborative spousal involvement by the spouse was associated with greater CPAP adherence (Baron et al 2011;Baron KG 2008). Given that women are more physically and emotionally reactive to relationship conflict (Kiecolt-Glaser and Newton 2001) and both marital status and relationship quality have been associated with women's sleep quality (Gallo et al 2003).…”

Section: Introductionmentioning

confidence: 96%

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Relationships and CPAP adherence among women with obstructive sleep apnea

Baron

Gunn

Wolfe

et al. 2017

Sleep Science Practice

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Background: Obstructive sleep apnea contributes to daytime sleepiness, poor quality of life and increased risk for heart disease and hypertension among women. Continuous positive airway pressure improves sleepiness and quality of life and may reduce health risks but few studies have evaluated predictors of adherence among women. The goal of this study was to evaluate the role of relationship factors in women's continuous positive airway pressure (CPAP) adherence and change in relationship quality among married/partnered women. Methods: Women recently diagnosed with obstructive sleep apnea completed relationship quality, social support questionnaires and spousal involvement interviews. CPAP adherence was collected at 12 weeks. Results: Data were available for 16 women. Average CPAP adherence was 3.6 SD = 2.7 h per night. Women with higher reports of social support had higher adherence. None of the unmarried/partnered participants were adherent to the recommendation of CPAP use ≥ 4 h per night at 12 week follow-up. Marital status was not associated with demographic, disease severity or social support measures. Relationship conflict among married/partnered participants was associated with lower adherence. In qualitative surveys, encouragement and support were the two most commonly reported types of partner involvement. Relationship quality did not change between baseline and 3 months. Conclusion: Results suggest relationship factors are robust predictors of CPAP adherence among women with obstructive sleep apnea.

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“…5 Moreover, there are data to suggest that social support has a favorable effect on promoting CPAP adherence. [6][7][8][9][10] ans receiving CPAP therapy for OSA. Additional objective was to obtain preliminary data on the effect of PBS on CPAP adherence, vigilance, patient activation, and self-efficacy in veterans receiving CPAP therapy for OSA.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

A Pilot Study Of CPAP Adherence Promotion By Peer Buddies With Sleep Apnea

Parthasarathy

Wendel

Haynes

et al. 2012

B108. Diagnostic and Therapeutic Approaches in Sleep Apnea

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BRIEF SUMMARYCurrent knowledge/Study Rationale: Poor adherence to the primary treatment of OSA-continuous positive airway pressure (CPAP) therapy-is common, and there is a paucity of easily accessible yet costeffective interventions that could promote CPAP adherence. Promoting adherence to therapy through peer-driven intervention is cost-effective and has met with modest success in other chronic conditions such as HIV, heart failure and diabetes mellitus, but whether such a peer-driven intervention can improve adherence to CPAP therapy is unknown. Study Impact: Our pilot study involved such a peer-driven intervention (experienced CPAP users called "peer-buddies") and suggests that such an intervention is feasible, results in high patient satisfaction, and promotes CPAP adherence. A larger, adequately powered study is needed, which, if successful, could potentially improve outcomes in a "patientcentered" and cost-effective manner.

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Spousal involvement in CPAP adherence among patients with obstructive sleep apnea

Abstract: Introduction: Little is known about the impact of spousal involvement on continuous positive airway pressure (CPAP) adherence. The aim of this study was

Cited by 74 publications

References 73 publications

Sleep Quality, Short-Term and Long-Term CPAP Adherence

Sleep Quality, Short-Term and Long-Term CPAP Adherence

Relationships and CPAP adherence among women with obstructive sleep apnea

A Pilot Study Of CPAP Adherence Promotion By Peer Buddies With Sleep Apnea

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