Psychologic Correlates of Compliance with Continuous Positive Airway Pressure

Study Objectives: To explore the relationship between psychologic variables measured prior to continuous positive airway pressure (CPAP) treatment and subsequent CPAP compliance.

Design: Participants were assigned to a CPAP treatment group. Psychologic questionnaires administered prior to the start of treatment assessed depression, anxiety, stress, anger or hostility, social support, social desirability, and coping. Polysomnography was performed on admission (prior to start of treatment) and at the end of 1 week of treatment. Compliance was measured nightly by an intemal clock counter in the CPAP unit and averaged over the 1-week treatment period.

Setting: N/A.

Participants: Twenty-three CPAP-naive patients with obstructive sleep apnea were enrolled in a study of the effects of CPAP on sympathetic nervous system functioning, quality of life, and psychologic functioning.

Interventions: N/A.

Measurements And Results: Objectively measured average daily compliance was significantly associated with a measure of coping strategies. Multiple regression analyses revealed that Active Ways of Coping accounted for a significant amount of variance in CPAP compliance, even after the respiratory disturbance index, daytime sleepiness, and Passive Ways of Coping were taken into account. No other psychologic variable assessed prior to CPAP treatment was associated with subsequent CPAP compliance.

Conclusions: These results suggest that individuals who engage in active coping strategies with new and difficult situations used CPAP more. It may be that encouraging patients to use coping techniques, such as planful problem solving, will help to improve compliance with CPAP.