Sleep Medicine
Volume 7, Issue 4 , Pages 350-356, June 2006

Social-cognitive correlates of CPAP adherence in experienced users

  • Carl J. Stepnowsky

      Affiliations

    • Health Services Research and Development Unit (111N-1), Veteran Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA
    • Department of Psychiatry, University of California, San Diego, CA, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 858 552 8585x5948; fax: +1 858 552 4321.
    • ,
  • Matthew R. Marler

      Affiliations

    • Department of Psychiatry, University of California, San Diego, CA, USA
    • ,
  • Joe Palau

      Affiliations

    • Health Services Research and Development Unit (111N-1), Veteran Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA
    • ,
  • J. Annette Brooks

      Affiliations

    • Behavioral Medicine Service, New Mexico Veterans Affairs Health Care System, Albuquerque, NM, USA

Received 22 July 2005; received in revised form 27 October 2005; accepted 6 November 2005.

Abstract 

Background and purposes

Obstructive sleep apnea (OSA) is a condition with serious medical and psychosocial consequences. However, poor adherence with nasal continuous positive airway pressure (CPAP) treatment limits the effectiveness of treatment. Behavior change factors offer one avenue of research to better understand the correlates of CPAP adherence.

Patients and methods

Fifty-eight participants who had been diagnosed with OSA and prescribed CPAP treatment agreed to complete questionnaires that assessed sleep apnea symptoms, behavior change factors, and CPAP side effects, and to have their CPAP data downloaded. Behavior change factors from both social cognitive theory (SCT) and the transtheoretical model (TM) were assessed. The primary aim of the study was to examine the relationship between these social-cognitive factors and objectively measured CPAP adherence.

Results

Participants had been using CPAP for a mean of 2.1 years. SCT variables (adjusted R2=0.115, P=.008) and TM variables (adjusted R2=0.157, P<.0001) each accounted for a statistically significant amount of variance in CPAP adherence.

Conclusions

The results suggest that social-cognitive factors may be associated with CPAP adherence in experienced CPAP users. The principal advantage to these theory-driven and empirically validated factors is that they are modifiable and can provide the basis for effective interventions to increase CPAP adherence.

Keywords: Sleep apnea syndromes, Continuous positive airway pressure, Patient compliance, Self efficacy, Models, psychological

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PII: S1389-9457(05)00269-8

doi:10.1016/j.sleep.2005.11.004

Sleep Medicine
Volume 7, Issue 4 , Pages 350-356, June 2006

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