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Cited by 48Obstructive Sleep Apnea ResearchSleep and related disordersMedication Adherence and Compliance

Self-Efficacy and Short-Term Adherence to Continuous Positive Airway Pressure Treatment in Children

Xanthopoulos, Melissa S., Kim, Ji Young, Blechner, Michael, Chang, Ming-yu, Menello, Mary Kate, Brown, Christina, Matthews, Edward, Weaver, Terri E. +2 more·2017·SLEEP
DOI 10.1093/sleep/zsx096
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Abstract

Study Objectives: Infants, children, and adolescents are increasingly being prescribed continuous positive airway pressure (CPAP) for treatment of obstructive sleep apnea syndrome (OSAS), yet adherence is often poor. The purpose of this study was to examine the relationship between caregiver and patient-reported health cognitions about CPAP prior to starting CPAP and CPAP adherence at 1 month. We hypothesized that greater caregiver-reported self-efficacy would be positively associated with CPAP adherence in children. We also evaluated patient-reported self-efficacy and caregiver- and patient-reported risk perception and outcome expectations as they related to adherence, as well as how demographic factors influenced these relationships. Methods: A pediatric modification of the Self-Efficacy Measure for Sleep Apnea Questionnaire was administered to children and adolescents with OSAS-prescribed CPAP and their caregivers during the clinical CPAP-initiation visit. The primary outcome variable for adherence was the average total minutes of CPAP usage across all days from the date that CPAP was initiated to 31 days later. Results: Unadjusted ordinary least-square regression showed a significant association between caregiver-reported self-efficacy and adherence (p = .007), indicating that mean daily CPAP usage increased by 48.4 minutes when caregiver-reported self-efficacy increased by one point (95% confidence interval 13.4-83.4 minutes). No other caregiver- or patient-reported cognitive health variables were related to CPAP use. Conclusions: This study indicates that caregiver CPAP-specific self-efficacy is an important factor to consider when starting youth on CPAP therapy for OSAS. Employing strategies to improve caregiver self-efficacy, beginning at CPAP initiation, may promote CPAP adherence.

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Crossref · 10.1093/sleep/zsx096

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  • Continuous positive airway pressure is considered the first-line treatment in pediatric obstructive sleep apnea without adenotonsillar hypertrophy, although with low tolerance of 25% to 50% and risk of craniofacial sequels after long-term use.

    “Continuous positive airway pressure (CPAP) is considered the first-line treatment in pediatric OSA without adenotonsillar hypertrophy, although with low tolerance (25% to 50%) 11 12 13 and risk of craniofacial sequels after long-term use. 14 15”

    From Mandibular Advancement Appliances in Pediatric Obstructive Sleep Apnea: An Umbrella Review (2023) · cites this paper as [13]

  • Evidence-based guidelines support continuous positive airway pressure treatment as an effective first-line treatment of obstructive sleep apnea in children without adenotonsillar hypertrophy, but it is complicated by low tolerance or high refusal (25%-50%).

    “Evidence-based guidelines support the use of continuous positive airway pressure treatment (CPAP) as an effective first-line treatment of OSA in children without adenotonsillar hypertrophy; however, this is complicated by low tolerance or high refusal level of treatment (25%–50%).”

    From Effectiveness of functional orthodontic appliances in obstructive sleep apnea treatment in children: literature review (2022) · cites this paper as [10]

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Authors
Xanthopoulos, M. S., Kim, J. Y., Blechner, M., Chang, M.-Y., Menello, M. K., Brown, C., Matthews, E., Weaver, T. E., Shults, J., & Marcus, C. L.
Affiliations
  • Children's Hospital of Philadelphia (US)
  • Chang Gung Children's Hospital (TW)
  • University of Illinois Chicago (US)
  • University of Pennsylvania (US)
ORCID
Venue
SLEEP
Publisher
Oxford University Press (OUP)
Published
2017-05-24
Volume
40
Issue
7
ISSN
  • 0161-8105 (ISSN-L)
  • 1550-9109
DOI
10.1093/sleep/zsx096
OpenAlex
W2620488255
Cited by
48
References
28
Citations by year
2026: 2 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 8 · 2021: 8 · 2020: 11 · 2019: 5 · 2018: 4
FWCI
4.05
Type
journal article
Language
en
Open access
closed
Locations
  • SLEEP (publishedVersion)
  • PubMed (publishedVersion)
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
continuous positive airway pressure, CPAP adherence, self-efficacy, obstructive sleep apnea, pediatric sleep apnea, caregiver self-efficacy, risk perception, outcome expectations, health cognitions, children and adolescents
MeSH terms
Adolescent, Child, Female, Humans, Male, Patient Compliance, Surveys and Questionnaires, Caregivers, Sleep Apnea, Obstructive, Self Efficacy, Continuous Positive Airway Pressure, Self Report

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