Summary and Update on Behavioral Interventions for Improving Adherence with Positive Airway Pressure Treatment in Adults

Angela L D'Rozario; Yael Galgut; Megan R Crawford; Delwyn J Bartlett

doi:10.1016/j.jsmc.2020.10.006

Summary and Update on Behavioral Interventions for Improving Adherence with Positive Airway Pressure Treatment in Adults

Sleep Med Clin. 2021 Mar;16(1):101-124. doi: 10.1016/j.jsmc.2020.10.006. Epub 2021 Jan 19.

Authors

Angela L D'Rozario¹, Yael Galgut², Megan R Crawford³, Delwyn J Bartlett⁴

Affiliations

¹ School of Psychology, Faculty of Science, Brain and Mind Centre and Charles Perkins Centre, The University of Sydney, Level 2, Building D17, Johns Hopkins Drive, Camperdown, New South Wales 2050, Australia; Sleep and Circadian Research Group, Woolcock Institute of Medical Research, The University of Sydney, PO Box M77, Missenden Road, Camperdown, Sydney, New South Wales 2050, Australia; Sydney Medical School, The University of Sydney. Electronic address: angela.drozario@sydney.edu.au.
² Sleep and Circadian Research Group, Woolcock Institute of Medical Research, The University of Sydney, PO Box M77, Missenden Road, Camperdown, Sydney, New South Wales 2050, Australia.
³ The University of Strathclyde, Graham Hills Building, 50 George Street, Glasgow G1 1QE, UK.
⁴ Sleep and Circadian Research Group, Woolcock Institute of Medical Research, The University of Sydney, PO Box M77, Missenden Road, Camperdown, Sydney, New South Wales 2050, Australia; Sydney Medical School, The University of Sydney.

PMID: 33485523
DOI: 10.1016/j.jsmc.2020.10.006

Abstract

Continuous positive airway pressure (PAP) is still the most efficacious treatment for obstructive sleep apnea when used effectively. Since the availability of PAP 39 years ago there have been considerable technological advances, such as quieter, lighter and smaller machines with better humidification. However, adherence to treatment is still a major problem. This article reviews studies published on behavioral interventions aimed at improving the uptake and maintenance of PAP treatment (January 2016-February 2020). It discusses underlying factors in the poor uptake and discontinuation of treatment and the role of qualitative research to better understand the perspective of the patients.

Keywords: Adherence; Behavioral interventions; Cognitive behavioral therapy; Compliance; Obstructive sleep apnea; Psychoeducation; Psychosocial factors; Sleep-disordered breathing.

Publication types

Review

MeSH terms

Adult
Cognitive Behavioral Therapy*
Continuous Positive Airway Pressure*
Humans
Patient Compliance / psychology*
Patient Compliance / statistics & numerical data
Randomized Controlled Trials as Topic
Sleep Apnea, Obstructive / therapy*