A randomized controlled trial of a multi-dimensional intervention to improve CPAP use and self-efficacy

Julie Tolson; Delwyn J Bartlett; Maree Barnes; Peter D Rochford; Amy S Jordan; Melinda L Jackson

doi:10.1016/j.sleep.2023.06.024

A randomized controlled trial of a multi-dimensional intervention to improve CPAP use and self-efficacy

Sleep Med. 2023 Sep:109:202-210. doi: 10.1016/j.sleep.2023.06.024. Epub 2023 Jul 3.

Authors

Julie Tolson¹, Delwyn J Bartlett², Maree Barnes³, Peter D Rochford⁴, Amy S Jordan⁵, Melinda L Jackson⁶

Affiliations

¹ Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia; Institute for Breathing and Sleep, Heidelberg, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Australia. Electronic address: julie.tolson@austin.org.au.
² Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, Australia.
³ Institute for Breathing and Sleep, Heidelberg, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Australia; Department of Medicine, The University of Melbourne, Parkville, Australia.
⁴ Institute for Breathing and Sleep, Heidelberg, Australia.
⁵ Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia; Institute for Breathing and Sleep, Heidelberg, Australia.
⁶ Institute for Breathing and Sleep, Heidelberg, Australia; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.

PMID: 37478656
DOI: 10.1016/j.sleep.2023.06.024

Abstract

Objectives: To assess the utility of a tailored intervention program to improve continuous positive airway pressure (CPAP) use and self-efficacy in individuals with obstructive sleep apnea (OSA).

Methods: 81 participants (mean age 52.1 ± 11.6 years; 35 females) with OSA were randomized to either a multi-dimensional intervention (PSY CPAP, n = 38) or treatment as usual (TAU CPAP, n = 43). The intervention included a psychoeducation session prior to CPAP initiation, a booster psychoeducation session in the first weeks of commencing CPAP, follow-up phone calls on days 1 and 7, and a review appointment on day 14. CPAP use was compared between the PSY CPAP and TAU CPAP groups at 1 week, 1 month, and 4 months. Self-efficacy scores (risk perception, outcome expectancies, and CPAP self-efficacy) were compared between groups following the initial psychoeducation session and again at 1 month and 4 months.

Results: CPAP use was higher in the PSY CPAP group compared to the TAU CPAP group for all time points (p = .02). Outcome expectancies improved significantly over time in PSY CPAP participants (p = .007). Change in risk perception was associated with CPAP use at 1 week (p = .02) for PSY CPAP participants. However, risk perception did not mediate the effect between group and CPAP use at 1 week.

Conclusions: Interventions designed to increase self-efficacy and administered prior to CPAP initiation, repeated in the early stages of CPAP therapy, and combined with a comprehensive follow-up regime are likely to improve CPAP use. Sustained improvement in CPAP use is the ultimate goal but remains to be investigated.

Keywords: Adherence; Continuous positive airway pressure; Obstructive sleep apnea; Psychoeducation intervention; Self-efficacy.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cognition
Continuous Positive Airway Pressure / methods
Female
Humans
Middle Aged
Motivation
Patient Compliance
Self Efficacy*
Sleep Apnea, Obstructive* / therapy

Associated data

ANZCTR/ACTRN12614000013662