PENN STATE (US) — People with obstructive sleep apnea are more likely to stick to prescribed treatment if they have the involved support of a parent or partner, a new study shows.
Obstructive sleep apnea—the most common type of sleep-disordered breathing—occurs when the upper airway collapses during sleep. Chances of it occurring become more elevated in obese people.
The first line of treatment is a noninvasive, in-home treatment called CPAP, continuous positive airway pressure therapy. But if patients don’t use the equipment properly or at all, it can’t help.
Full face CPAP mask. (Credit: JoJoJo04 / Wikimedia Commons)
“There is inconsistency in how people use and adhere to CPAP,” says Amy M. Sawyer, assistant professor of nursing at Penn State. “Patients are expected to use CPAP for the eight hours or so that they are asleep. Unfortunately, most patients do not use CPAP for the duration of their sleep time.”
A CPAP machine is connected to a nasal, oral, or full-face mask. The CPAP machine delivers positive pressure by air, which keeps the upper airway open and unable to collapse—a definitive problem of obstructive sleep apnea sufferers.
Keeping the airway open prevents drops in oxygen levels during sleep and reduces sleep disturbance. As a result, people treated with CPAP have less daytime sleepiness and better cognitive function. Treating obstructive sleep apnea also lessens other health risks, including cardiovascular disease and diabetes.
Sawyer and colleagues looked at 80 studies to determine what works and what factors are important to consider when helping obstructive sleep apnea people 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 report in a paper in Sleep Medicine Reviews.
A variety of factors can affect whether or not patients follow through on prescribed treatment—disease and patient characteristics, treatment requirements, technological device factors, and side effects, and psychological and social factors. One of the studies 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 such as weekly phone calls or wireless telemonitoring to help patients adhere to treatment.
CPAP adherence intervention should be done on a case-by-case basis. If social support is involved, such as a parent or partner, 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 don’t have social support available to them, telecommunications may be a good alternative.
“This study highlights the need for individualized considerations for initiating and managing CPAP treatment with diverse patient groups,” says Sawyer.
Researchers from the University of Pennsylvania, and the University of Illinois at Chicago contributed to the study that was funded by the National Institutes of Health and the National Institute of Nursing Research.
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