Increased Adherence to CPAP With a Group Cognitive Behavioral Treatment Intervention: A Randomized Trial
Abstract
STUDY OBJECTIVE: To improve adherence to continuous positive airway pressure (CPAP) treatment in participants with obstructive sleep apnea (OSA) using a cognitive behavioral therapy (CBT) intervention. DESIGN: A randomized controlled trial. SETTING: A major teaching hospital in Sydney (2005). PARTICIPANTS: One hundred individuals (96 men), ranging in age from 32 to 81 years, diagnosed with OSA. INTERVENTION: Two 1-hour CBT interventions (including a video of real CPAP users) plus treatment as usual (mask fitting and information) or treatment as usual only. MEASUREMENTS AND RESULTS: Hours of CPAP usage was assessed at 7 nights and 28 nights. Adherence was defined as usage at least 4 hours per night. Questionnaires measuring self-efficacy, social support, and expectancy (mediators of adherence) were given after intervention or after usual treatment. A higher adherence to CPAP therapy was found in the CBT group (2.9 hours difference) relative to treatment as usual (P < 0.001) at 28 days. Only 4 participants in the CBT group did not initiate treatments after their titration study, compared with 15 in the treatment as usual group (P < 0.02). The CBT group had significantly higher scores for self-efficacy (P < 0.001) and social support P < 0.008) but not for expectancy. CONCLUSIONS: The CBT intervention resulted in both increased adherence and "uptake" of CPAP and therefore would be expected to reduce the social, economic, and health-related consequences of untreated OSA.
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- Authors
- Richards, D., Bartlett, D. J., Wong, K., Malouff, J., & Grunstein, R. R.
- Affiliations
- The University of Sydney (AU)
- University of New England (AU)
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-05
- Volume
- 30
- Issue
- 5
- Pages
- 635-640
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- OpenAlex
- W41398982
- Semantic Scholar
- 5463d128e42db81cb452780513098f0ea697df91
- Cited by
- 257
- References
- 36
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 11 · 2023: 7 · 2022: 17 · 2021: 11 · 2020: 15 · 2019: 13 · 2018: 10 · 2017: 11 · 2016: 18 · 2015: 12 · 2014: 26 · 2013: 24 · 2012: 14
- FWCI
- 8.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- SLEEP (publishedVersion)
- PubMed (publishedVersion)
- EPubDev Repository (submittedVersion)
- RUNE (Research UNE) (submittedVersion)
- Funders
- National Health and Medical Research Council
- 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, cognitive behavioral therapy, group intervention, self-efficacy, social support, treatment uptake, CPAP titration, sleep apnea treatment
- MeSH terms
- Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Middle Aged, Patient Compliance, Patient Education as Topic, Psychotherapy, Group, Cognitive Behavioral Therapy, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
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