People with obstructive sleep apnea are more likely to stick to prescribed treatment when a partner or parent is involved with their treatment, according to a team of sleep researchers.
Amy M. Sawyer, assistant professor of nursing, Penn State, and her team are looking for the best ways to encourage patients to adhere to CPAP.
"There is inconsistency in how people use and adhere to CPAP," said Sawyer. "Patients are expected to use CPAP for the 8 hours or so that they are asleep. Unfortunately, most patients do not use CPAP for the duration of their sleep time."
The researchers were looking at different types of interventions to promote CPAP use, the team reports in the current issue of Sleep Medicine Reviews. Sawyer and her team looked at 80 studies to determine what works and what factors are important to consider when helping obstructive sleep apnea patients start CPAP therapy.
"Collectively, these studies suggest that patients who experience difficulties and proactively seek solutions to resolve problems (active coping) are more likely to be adherent than those who use passive coping styles," the researchers noted.
Many different factors can affect whether patients follow through on their prescribed treatment—disease and patient characteristics, treatment requirements, technological device factors and side effects, and psychological and social factors. One of the studies that the researchers reviewed showed that about half of newly diagnosed sleep apnea patients would not use CPAP if it made them feel claustrophobic.
Several intervention studies use telecommunications to help patients adhere to their treatment. This method can involve weekly phone calls or wireless telemonitoring of patients.
The researchers determined that CPAP adherence intervention should be done on a case-by-case basis. If social support is involved, from a parent or partner, for example, patients are likely to continue their treatment. With social support sources providing insight, CPAP users are more readily able to identify their own improvements with treatment. If patients do not have social support available to them, then telecommunications may be a good option for them.
"This study highlights the need for individualized considerations for initiating and managing CPAP treatment with diverse patient groups," said Sawyer.