A systematic review of CPAP adherence across age groups: Clinical and empiric insights for developing CPAP adherence interventions
Open accessAbstract
Continuous positive airway pressure (CPAP) is a highly efficacious treatment for obstructive sleep apnea (OSA) but adherence to the treatment limits its overall effectiveness across all age groups of patients. Factors that influence adherence to CPAP include disease and patient characteristics, treatment titration procedures, technological device factors and side effects, and psychological and social factors. These influential factors have guided the development of interventions to promote CPAP adherence. Various intervention strategies have been described and include educational, technological, psychosocial, pharmacological, and multi-dimensional approaches. Though evidence to date has led to innovative strategies that address adherence in CPAP-treated children, adults, and older adults, significant opportunities exist to develop and test interventions that are clinically applicable, specific to subgroups of patients likely to demonstrate poor adherence, and address the multifactorial nature of CPAP adherence. The translation of CPAP adherence promotion interventions to clinical practice is imperative to improve health and functional outcomes in all persons with CPAP-treated OSA.
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Observational data demonstrate that increased knowledge of OSA and its long-term impacts, as well as the beneficial effects of PAP, predict adherence.
“Observational data have demonstrated that increased knowledge of OSA and its long-term impacts, as well as the beneficial effects of PAP predict adherence, raising interest in educational interventions.26”
From Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment (2019) · cites this paper as [26]
In “Psychological and social factors” (page unavailable), the review reports that beliefs about OSA and CPAP formed during education and early treatment influence CPAP use; it also describes nonadherent patients identifying few CPAP benefits. But “Educational strategies” (page unavailable) says that knowledge influencing adherence is an assumption and that educational studies had not measured knowledge as a mediator. The review therefore does not establish the claimed prediction by increased knowledge of OSA’s long-term impacts and PAP benefits. (LLM, conf=0.86)
Experimental — accuracy not yet measured
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- Authors
- Sawyer, A. M., Gooneratne, N. S., Marcus, C. L., Ofer, D., Richards, K. C., & Weaver, T. E.
- Affiliations
- Philadelphia VA Medical Center (US)
- University of Pennsylvania (US)
- Children's Hospital of Philadelphia (US)
- University of Illinois Chicago (US)
- Corresponding author
- Sawyer, Amy M.
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2011-12
- Volume
- 15
- Issue
- 6
- Pages
- 343-356
- ISSN
- 1087-0792 (ISSN-L)
- PMC
- PMC3202028
- OpenAlex
- W2167330814
- Semantic Scholar
- eedb56e378d918132bc2ebe49ba94e0614e78a04
- Cited by
- 900
- References
- 98
- Citations by year
- 2026: 36 · 2025: 59 · 2024: 72 · 2023: 70 · 2022: 88 · 2021: 89 · 2020: 89 · 2019: 70 · 2018: 70 · 2017: 63 · 2016: 61 · 2015: 33 · 2014: 44 · 2013: 36 · 2012: 15
- FWCI
- 3.44
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Nursing Research (K99NR011173, R00NR011173)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- CPAP adherence, continuous positive airway pressure, obstructive sleep apnea, adherence interventions, children, older adults, treatment side effects, CPAP titration, psychosocial factors, patient education, device technology, pharmacological interventions
- MeSH terms
- Adult, Age Factors, Humans, Patient Compliance, Psychology, Severity of Illness Index, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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