A preliminary study of psychological factors affecting patients' acceptance of CPAP therapy for sleep apnoea syndrome

Abstract 

Background

Many patients abandon continuous positive airway pressure (CPAP) treatment after initial acceptance. This may be for physical or psychological reasons.

Methods

We have carried out semi-structured interviews, constructed from the Health Belief Model (HBM) with a convenience sample of patients who had recently abandoned CPAP treatment after at least 6 months of use. We explored their understanding and experiences of their OSA and of the CPAP therapy and their reasons for stopping treatment.

Results

Nine patients were interviewed (age 32–70 years; 8 males). Four patients were not clear about the nature, severity, or consequences of sleep apnoea syndrome (SAS) and did not consider themselves to be ill. Three expected to be cured by the machine. Only one patient spoke of life-threatening risk. Eight of the nine patients had other health disorders. Seven stopped CPAP because of negative experiences, including problems with the mask and noise from the machine. Two patients felt ‘liberated’ on stopping treatment.

Conclusions

Studies at the initiation stage of CPAP treatment are needed in order to identify factors impeding acceptance, which can be addressed early. The Health Belief Model, which emphasises subjective health experience and patients' beliefs about treatment, may be a useful tool for such investigations.

Keywords: Sleep apnoea syndrome, Continuous positive airway pressure, Treatment compliance, Health Belief Model, Psychology, Quality of life