INTRODUCTION: Poor adherence to continuous positive airway pressure (CPAP) treatment in obstructive sleep apnea (OSA) adversely affects the effectiveness of this therapy. This randomized controlled trial (RCT) examined the efficacy of a brief motivational enhancement education program in improving adherence to CPAP treatment in OSA subjects. METHODS: Newly diagnosed OSA subjects were recruited into this RCT. The control group received usual advice on the importance of CPAP therapy and its care. Intervention group received usual care plus brief motivational enhancement education program directed at enhancing the subjects' knowledge, motivation and self-efficacy to use CPAP through the use of a 25-minute video, a 20-minute patient-centered interview and a 10-minute telephone follow up. Self-reported daytime sleepiness adherence-related cognitions and quality of life were assessed at 1 month and 3 months. CPAP usage data was downloaded at the completion of this 3-month study. RESULTS: 100 OSA subjects (mean +/- SD: age 52 +/- 10 years, Epworth Sleepiess Scales (ESS) 9 +/- 5, median Apnea Hypopnea Index of 29 (20 to 53) events/hour) prescribed CPAP treatment were recruited. The intervention group had better CPAP use (higher daily CPAP usage by 2 hours/day (Cohen d = 1.33, p < 0.001), a four-fold increase in the number using CPAP for >= 70% of days with >= 4 hours per day (p < 0.001)), and greater improvements in daytime sleepiness (ESS) by 2.2 units (p = 0.001) and treatment self-efficacy by 0.2 unit (p = 0.012) compared to the control group. CONCLUSIONS: OSA subjects who received motivational enhancement education in addition to usual care were more likely to show better adherence to CPAP treatment, with greater improvements in treatment self-efficacy and daytime sleepiness.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher