A New Characterization of Adherence Patterns to Auto-adjusting Positive Airway Pressure in Severe Obstructive Sleep Apnea Syndrome: Clinical and Psychological Determinants

Overview

Journal Sleep Breath

Publisher Springer

Date 2013 Feb 7

PMID 23386372

Citations 5

Authors

Rute Sampaio

M Graca Pereira

Joao C Winck

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim of this study was to examine the joint role of demographic, clinical, psychological and family coping variables as predictors of adherence patterns to auto-adjusting positive airway pressure (APAP).

Methods: A total of 153 patients diagnosed with obstructive sleep apnea syndrome (OSAS) were assessed during a 6-months APAP treatment period. All patients underwent psychological evaluation prior to treatment (T1) and 1 to 3 months (T2) and 4 to 6 months (T3) post-APAP treatment. Of these, 107 patients maintained a stable adherence pattern to APAP during the treatment period.

Results: Forty-seven percent were poorly adherent, 27 % were moderately adherent and 26 % were optimally adherent OSAS patients. Several factors distinguished the three adherence patterns and some of these emerged as the main predictors. In T1, the first model included age, apnea-hypopnea index, outcome expectations and coping spiritual support, as main predictors to distinguish adherence patterns. In T2 and T3, two models emerged adjusted to the variables of model 1 that included leakage, self-efficacy, mobilizing family acquire/accept support and reframing in model 2 and self-efficacy in model 3. Generally, the areas under the ROC curve, presented a good discrimination.

Conclusions: Findings revealed an integrative heuristic model that accounted for the joint influence of demographic, clinical, psychological, and family coping factors on poor, moderate, and optimal adherence patterns.

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References

Weaver T, Kribbs N, Pack A, Kline L, Chugh D, Maislin G . Night-to-night variability in CPAP use over the first three months of treatment. Sleep. 1997; 20(4):278-83. DOI: 10.1093/sleep/20.4.278. View

Weaver T, Maislin G, Dinges D, Bloxham T, George C, Greenberg H . Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep. 2007; 30(6):711-9. PMC: 1978355. DOI: 10.1093/sleep/30.6.711. View

Carter 3rd R, Watenpaugh D . Obesity and obstructive sleep apnea: or is it OSA and obesity?. Pathophysiology. 2008; 15(2):71-7. DOI: 10.1016/j.pathophys.2008.04.009. View

Xu T, Li T, Wei D, Feng Y, Xian L, Wu H . Effect of automatic versus fixed continuous positive airway pressure for the treatment of obstructive sleep apnea: an up-to-date meta-analysis. Sleep Breath. 2011; 16(4):1017-26. DOI: 10.1007/s11325-011-0626-6. View

Lewis K, Seale L, Bartle I, Watkins A, Ebden P . Early predictors of CPAP use for the treatment of obstructive sleep apnea. Sleep. 2004; 27(1):134-8. DOI: 10.1093/sleep/27.1.134. View

Wolkove N, Baltzan M, Kamel H, Dabrusin R, Palayew M . Long-term compliance with continuous positive airway pressure in patients with obstructive sleep apnea. Can Respir J. 2008; 15(7):365-9. PMC: 2679572. DOI: 10.1155/2008/534372. View

Prochaska J, Redding C, Harlow L, Rossi J, Velicer W . The transtheoretical model of change and HIV prevention: a review. Health Educ Q. 1994; 21(4):471-86. DOI: 10.1177/109019819402100410. View

Haniffa M, Lasserson T, Smith I . Interventions to improve compliance with continuous positive airway pressure for obstructive sleep apnoea. Cochrane Database Syst Rev. 2004; (4):CD003531. DOI: 10.1002/14651858.CD003531.pub2. View

Aloia M, Arnedt J, Stanchina M, Millman R . How early in treatment is PAP adherence established? Revisiting night-to-night variability. Behav Sleep Med. 2007; 5(3):229-40. DOI: 10.1080/15402000701264005. View

10.

Valentin A, Subramanian S, Quan S, Berry R, Parthasarathy S . Air leak is associated with poor adherence to autoPAP therapy. Sleep. 2011; 34(6):801-6. PMC: 3098948. DOI: 10.5665/SLEEP.1054. View

11.

Mulgrew A, Cheema R, Fleetham J, Ryan C, Ayas N . Efficacy and patient satisfaction with autoadjusting CPAP with variable expiratory pressure vs standard CPAP: a two-night randomized crossover trial. Sleep Breath. 2006; 11(1):31-7. PMC: 1794625. DOI: 10.1007/s11325-006-0078-6. View

12.

Loube D, Gay P, Strohl K, Pack A, White D, Collop N . Indications for positive airway pressure treatment of adult obstructive sleep apnea patients: a consensus statement. Chest. 1999; 115(3):863-6. DOI: 10.1378/chest.115.3.863. View

13.

Campos-Rodriguez F, Pena-Grinan N, Reyes-Nunez N, de la Cruz-Moron I, Perez-Ronchel J, De la Vega-Gallardo F . Mortality in obstructive sleep apnea-hypopnea patients treated with positive airway pressure. Chest. 2005; 128(2):624-33. DOI: 10.1378/chest.128.2.624. View

14.

Stroup A, Smith K . Familial effects of BRCA1 genetic mutation testing: changes in perceived family functioning. Cancer Epidemiol Biomarkers Prev. 2007; 16(1):135-41. DOI: 10.1158/1055-9965.EPI-06-0178. View

15.

Cilli A, Uzun R, Bilge U . The accuracy of autotitrating CPAP-determined residual apnea-hypopnea index. Sleep Breath. 2012; 17(1):189-93. DOI: 10.1007/s11325-012-0670-x. View

16.

Ockene I, Hayman L, Pasternak R, Schron E, Dunbar-Jacob J . Task force #4--adherence issues and behavior changes: achieving a long-term solution. 33rd Bethesda Conference. J Am Coll Cardiol. 2002; 40(4):630-40. DOI: 10.1016/s0735-1097(02)02078-8. View

17.

Poulet C, Veale D, Arnol N, Levy P, Pepin J, Tyrrell J . Psychological variables as predictors of adherence to treatment by continuous positive airway pressure. Sleep Med. 2009; 10(9):993-9. DOI: 10.1016/j.sleep.2009.01.007. View

18.

Sawyer A, Deatrick J, Kuna S, Weaver T . Differences in perceptions of the diagnosis and treatment of obstructive sleep apnea and continuous positive airway pressure therapy among adherers and nonadherers. Qual Health Res. 2010; 20(7):873-92. PMC: 2978511. DOI: 10.1177/1049732310365502. View

19.

Lindberg E, Berne C, Elmasry A, Hedner J, Janson C . CPAP treatment of a population-based sample--what are the benefits and the treatment compliance?. Sleep Med. 2006; 7(7):553-60. DOI: 10.1016/j.sleep.2005.12.010. View

20.

Gay P, Weaver T, Loube D, Iber C . Evaluation of positive airway pressure treatment for sleep related breathing disorders in adults. Sleep. 2006; 29(3):381-401. DOI: 10.1093/sleep/29.3.381. View