Psychological and environmental factors important in keeping patients on CPAP

A new study that was released at the 22nd Annual meeting of the Associated Professional Sleep Societies shows that psychological and environmental factors, as opposed to the severity of disease and quantifiable physiological indices, hold the greatest sway in a patient’s decision to stick with continuous positive airway pressure therapy for obstructive sleep apnea.

The study looked at 77 consecutive patients who were diagnosed with obstructive sleep apnea for the first time. The subject filled out surveys prior to continuous positive airway pressure therapy. These surveys asked about the attitude of the patient; outcome expectancy, self-efficacy, the results of sleepiness, and the felt risks of negative health results. A polysomnogram was also administered to each patient.

The study showed that the Health Beliefs Model measures, on their own, explained 21.8 percent of the variance in the adherence of patients to CPAP therapy. 31.8 percent of variance was explained when both the Health Beliefs Model measures and physiological measures were combined.

Simon S. Smith, of Queensland University of Technology in Carseldine, Victoria, Australia, was the author of the study.

"OSA is a serious and common disorder. It has high public health and social costs. CPAP therapy can be very effective in treating OSA. Unfortunately adherence to the treatment is often poor. Biomedical factors, such as disease severity, don't seem to explain this adherence problem. Our study looked at psychological factors, such as the impact of OSA on lifestyle, and beliefs about the effects of CPAP treatment,” said Smith. “We found that these Health Beliefs factors explained more than 20 percent of the variance in adherence. Importantly, we found this before patients had even used CPAP. This tells us that patients have developed beliefs and expectations about their health, even before they have tried CPAP treatment. We may be able to improve adherence to CPAP, and improve the treatment of OSA, by addressing some of these health beliefs directly.”

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