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Abstract

Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing. Continuous positive airway pressure (CPAP) is the treatment of choice, but adherence is poor, contributing to a myriad of comorbidities that increase health burden. The study purpose was to examine the effect of the CPAP-SAVER intervention on adherence among adults with newly diagnosed OSA. Sixty-six participants were randomly assigned to intervention or standard care groups. Data were analyzed using chi-square, t-tests, and correlations. At one month, there was no significant difference in adherence between groups; CPAP beliefs and attitude were significantly higher and attitude significantly increased for the intervention group. Focus on CPAP beliefs and attitude by practitioners may impact CPAP adherence. With further research and replication of this study in larger samples to determine generalizability, the CPAP-SAVER intervention may provide underpinnings for the eventual development of an OSA-CPAP adherence management protocol.

Keywords

obstructive sleep apnea CPAP adherence intervention CPAP-SAVER

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References

Aboussouan

Zahand

Podmore

(2010). This thing is impossible! In Foldvary-Schaefer

Krishna

Budur

(Eds.), A case a week: Sleep disorders from the Cleveland clinic (pp. 151-159). New York, NY: Oxford University Press.

Ajzen

(1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211. doi:10.1016/0749-5978(91)90020-T

Ajzen

(2005). Attitudes, personality and behavior (2nd ed.). Maidenhead, England: Open University Press.

Ajzen

(2011). Behavioral interventions: Design and evaluation guided by the theory of planned behavior. In Mark

M. M.

Donaldson

S. I.

Campbell

(Eds.), Social psychology and evaluation (pp. 74-100). New York, NY: Guilford Press.

Aloia

M. S.

(2011). Understanding the problem of poor CPAP adherence. Sleep Medicine Reviews, 15, 341-342. doi:10.1016/j.smrv.2011.04.002

Aloia

M. S.

Arnedt

J. T.

Stanchina

Millman

R. P.

(2007). How early in treatment is PAP adherence established? Revisiting night-to-night variability. Behavioral Sleep Medicine, 5, 229-240. doi:10.1080/15402000701264005

American Academy of Sleep Medicine. (2014). Rising prevalence of sleep apnea in US threatens public health. Retrieved from http://www.aasmnet.org/articles.aspx?id=5043

Ayow

T. M.

Paquet

Dallaire

Purden

Champagne

K. A.

(2009). Factors influencing the use and nonuse of continuous positive airway pressure therapy: A comparative case study. Rehabilitation Nursing, 34, 230-236.

Beck

A. T.

Steer

R. A.

(1993). Beck anxiety inventory (1993 ed.). San Antonio, TX: The Psychological Corporation.

10.

Cao

M. T.

Sternbach

J. M.

Guilleminault

(2017). Continuous positive airway pressure therapy in obstructive sleep apnea: Benefits and alternatives. Expert Review of Respiratory Medicine, 11, 259-272. doi:10.1080.17476348.2017.1305893

11.

DeCoster

Iselin

A.-M.

(2006). Double Data Entry [Computer Software]. Charlottesville, VA: Author.

12.

Epstein

L. J.

Kristo

Strollo

P. J.

Jr. Friedman

Malhotra

Patil

S. P.

. . .Weinstein

M. D.

(2009). Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. Journal of Clinical Sleep Medicine, 5, 263-276.

13.

Faul

Erdfelder

Lang

A. G.

Buchner

(2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175-191.

14.

Francis

Eccles

M. P.

Johnston

Walker

A. E.

Grimshaw

J. M.

Foy

. . . Bonetti

(2004). Constructing questionnaires based on the theory of planned behaviour: A manual for health services researchers. Newcastle upon Tyne, UK: Centre for Health Services Research, University of Newcastle upon Tyne.

15.

Gay

Weaver

Loube

Iber

(2006). Evaluation of positive airway pressure treatment for sleep related breathing disorders in adults. Sleep, 29, 381-401.

16.

IBM. (2016). IBM SPSS Statistics Version 24 [Computer Software]. Armonk, NY: Author.

17.

Kapur

V. K.

(2010). Obstructive sleep apnea: Diagnosis, epidemiology, and economics. Respiratory Care, 55, 1155-1167.

18.

Kjelsberg

F. N.

Ruud

E. A.

Stavem

(2005). Predictors of symptoms of anxiety and depression in obstructive sleep apnea. Sleep Medicine, 6, 341-346.

19.

Niven

Nevill

Sayers

Cullen

(2012). Predictors of rehabilitation intention and behavior following anterior cruciate ligament surgery: An application of the Theory of Planned Behavior. Scandinavian Journal of Medicine & Science in Sports, 22, 316-322. doi:10.1111/j.1600-0838.2010.01236.x

20.

Park

J. G.

Ramar

Olson

E. J.

(2011). Updates on definition, consequences, and management of obstructive sleep apnea. Mayo Clinic Proceedings, 86, 549-555. doi:10.4065/mcp.2010.0810

21.

Peppard

P. E.

Young

Barnet

J. H.

Palta

Hagen

E. W.

Hia

K. M.

(2013). Increased prevalence of sleep-disordered breathing in adults. American Journal of Epidemiology, 177, 1006-1014. doi:10.1093/aje/kws342

22.

Poulet

Veale

Arnol

Levy

Pepin

J. L.

Tyrrell

(2009). Psychological variables as predictors of adherence to treatment by continuous positive airway pressure. Sleep Medicine, 10, 993-999. doi:10.1016/j.sleep.2009.01.007

23.

Qaseem

Holty

J. E. C.

Owens

D. K.

Dallas

Starkey

Shekelle

(2013). Management of obstructive sleep apnea in adults: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 159, 471-483.

24.

Rakel

R. E.

(2009). Clinical and societal consequences of obstructive sleep apnea and excessive daytime sleepiness. Postgraduate Medicine, 121, 86-95. doi:10.3810/pgm.2009.01.1957

25.

Salepci

Caglayan

Kiral

Parmaksiz

Comert

S. S.

Sarac

. . .Gungor

G. A.

(2013). CPAP adherence of patients with obstructive sleep apnea. Respiratory Care, 58, 1467-1473. doi:10.4187/respcare.02139

26.

Sanford

S. D.

Bush

A. J.

Stone

K. C.

Lichstein

K. L.

Aguillard

(2008). Psychometric evaluation of the Beck Anxiety Inventory: A sample with sleep-disordered breathing. Behavioral Sleep Medicine, 6, 193-205. doi:10.1080/15402000802162596

27.

Sawyer

A. M.

Gooneratne

N. S.

Marcus

C. L.

Ofer

Richards

K. C.

Weaver

(2011). A systematic review of CPAP adherence across age groups: Clinical and empiric insights for developing CPAP adherence interventions. Sleep Medicine Reviews, 15, 343-356. doi:10.1016/j.smrv.2011.01.003

28.

Shapiro

A. L.

(2014). Anxiety in middle-aged men with obstructive sleep apnea: State of the science. Journal of the American Association of Nurse Practitioners, 26, 689-695. doi:10.1002/2327-6924.12118

29.

Shapiro

A. L.

Culp

Chertok

(2014). OSA symptoms associated with and predictive of anxiety in middle-aged men: Secondary analysis of NHANES data. Archives of Psychiatric Nursing, 28, 200-205. doi:10.1016/j.apnu.2014.02.002

30.

Shapiro

A. L.

McCrone

(2017). CPAP nonadherence issues in a small sample of men with obstructive sleep apnea. Applied Nursing Research, 36, 81-83. doi:10.1016/j.apnr.2017.06.001

31.

Shapiro

G. K.

Shapiro

C. M.

(2010). Factors that influence CPAP adherence: An overview. Sleeping and Breathing, 14, 323-335. doi:10.1007/s11325-010-0391-y

32.

Smith

Lang

Sullivan

Warren

(2004a). Two new tools for assessing patients’ knowledge and beliefs about obstructive sleep apnea and continuous positive airway pressure therapy. Sleep Medicine, 5, 359-367. doi:10.1016/j.sleep.2003.12.007

33.

Smith

S. S.

Lang

C. P.

Sullivan

K. A.

Warren

(2004b). A preliminary investigation of the effectiveness of a sleep apnea education program. Journal of Psychosomatic Research, 56, 245-249. doi:10.1016/S0022-3999(03)00545-2

34.

Tarasiuk

Reuveni

(2013). The economic impact of obstructive sleep apnea. Current Opinion in Pulmonary Medicine, 19, 639-644. doi:10.1097/MCP.0b013e3283659e1e

35.

US Department of Labor: Bureau of Labor Statistics. (2016). Occupational outlook handbook. Washington, DC: Author.

36.

Ward

Hoare

K. J.

Gott

(2014). What is known about the experiences of using CPAP for OSA from the users’ perspective? A systematic integrative literature review. Sleep Medicine Reviews, 18, 357-366. doi:10.1016/j.smrv.2014.01.001

37.

Weaver

T. E.

Sawyer

A. M.

(2010). Adherence to continuous positive airway pressure treatment for obstructive sleep apnoea: Implications for future interventions. Indian Journal of Medical Research, 131, 245-258.

38.

White

K. M.

Terry

D. J.

Troup

Rempel

L. A.

Norman

Mummery

. . . Kenardy

(2012). An extended theory of planned behavior intervention for older adults with type 2 diabetes and cardiovascular disease. Journal of Aging and Physical Activity, 20, 281-299.

39.

Willman

Igelstrom

Martin

Asenlof

(2012). Experiences with CPAP treatment in patients with obstructive sleep apnea syndrome and obesity. Advances in Physiotherapy, 14, 166-174. doi:10.3109/14038196.2012.704944

40.

Liang

Weaver

T. E.

(2008). Predictors of health-related quality of life in patients with obstructive sleep apnoea. Journal of Advanced Nursing, 63,54-63. doi:10.1111/j.1365-2648.2008.04652.x

Effect of the CPAP-SAVER Intervention on Adherence

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