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Cited by 149Obstructive Sleep Apnea ResearchSleep and related disordersTemporomandibular Joint Disorders

The DOI matches its Crossref record; 37 of the 40 references it cites were found in a registry or an index.

Sleep maintenance insomnia complaints predict poor CPAP adherence: A clinical case series

Wickwire, Emerson M., Smith, Michael T., Birnbaum, Sandra, Collop, Nancy A.·2010·Sleep Medicine
DOI 10.1016/j.sleep.2010.03.012
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Abstract

Background Although CPAP is a highly efficacious treatment for obstructive sleep apnea (OSA), low adherence presents a significant challenge for sleep medicine clinicians. The present study aimed to evaluate the relationship between insomnia symptoms and CPAP use. We hypothesized that pre-treatment insomnia complaints would be associated with poorer CPAP adherence at clinical follow-up.Methods This was a retrospective chart review of 232 patients (56.5% men, mean age=53.6+/-12.4years) newly diagnosed with OSA (mean AHI=41.8+/-27.7) and prescribed CPAP in the Johns Hopkins Sleep Disorder Center. Difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening were measured via three self-report items. CPAP use was measured via objective electronic monitoring cards.Results Thirty-seven percent of the sample reported at least one frequent insomnia complaint, with 23.7% reporting difficulty maintaining sleep, 20.6% reporting early morning awakening and 16.6% reporting difficulty initiating sleep. After controlling for age and gender, sleep maintenance insomnia displayed a statistically significant negative relationship with average nightly minutes of CPAP use (p<.05) as well as adherence status as defined by the Centers for Medicaid and Medicare Services (p<.02).Conclusions To our knowledge, these are the first empirical data to document that insomnia can be a risk factor for poorer CPAP adherence. Identifying and reducing insomnia complaints among patients prescribed CPAP may be a straightforward and cost-effective way to increase CPAP adherence.

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Crossref · 10.1016/j.sleep.2010.03.012

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  1. Wickwire, 2009, Behavioral management of sleep-disordered breathing, Prim Psychiatry, 16, 34

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Metadata

Authors
Wickwire, E. M., Smith, M. T., Birnbaum, S., & Collop, N. A.
Affiliations
Johns Hopkins University (US)
Corresponding author
Wickwire, Emerson M.
ORCID
Venue
Sleep Medicine
Publisher
Elsevier BV
Published
2010-09
Volume
11
Issue
8
Pages
772-776
ISSN
1389-9457 (ISSN-L)
DOI
10.1016/j.sleep.2010.03.012
OpenAlex
W2049525773
Cited by
149
References
40
Citations by year
2026: 5 · 2025: 13 · 2024: 8 · 2023: 10 · 2022: 15 · 2021: 8 · 2020: 11 · 2019: 12 · 2018: 10 · 2017: 8 · 2016: 5 · 2015: 4 · 2014: 10 · 2013: 16 · 2012: 8
FWCI
6.50
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Sleep Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Dentistry › Oral Surgery › Temporomandibular Joint Disorders
Keywords
sleep maintenance insomnia, CPAP adherence, obstructive sleep apnea, insomnia symptoms, early morning awakening, difficulty initiating sleep
MeSH terms
Adult, Aged, Female, Follow-Up Studies, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Patient Compliance, Predictive Value of Tests, Retrospective Studies, Risk Factors, Logistic Models, Treatment Outcome, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure

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