Improving Compliance with Nasal CPAP and Vigilance in Older Adults with OSAHS

Abstract

The present study examined the efficacy of a cognitive-behavioral intervention at improving compliance with CPAP and vigilance in older adults with obstructive sleep apnea/hypopnea syndrome (OSAHS). Participants included 12 subjects who were randomized into one of two groups controlling for age, education, disease severity, and vigilance. The experimental group received two 45-min sessions designed to educate subjects on the consequences of OSAHS and the efficacy of CPAP. The control group received the same extent of therapist contact but did not receive information on OSAHS or CPAP. All subjects were administered a test of vigilance both before and after the study. Compliance data were collected using CPAP devices with internal microprocessors at were read at 1, 4, and 12 weeks after treatment initiation. The results showed that the experimental condition did not enhance compliance after 1 week of treatment but did so by the 12-week follow-up. Subjects in the experimental condition had a run time of 3.2-h per night longer than did those in the control group. Those using CPAP more regularly at 12 weeks also showed greater improvement on vigilance at follow-up. Performance on vigilance testing before the introduction of CPAP was predictive of CPAP use at 12 weeks. In conclusion, a modest cognitive-behavioral intervention may substantially increase CPAP use and vigilance in older adults.

Prevalence of obstructive sleep apnea syndrome and CPAP adherence in the elderly Chinese population

“…These CPAP users clearly had higher BMI and neck circumference, and more severe SDB, as reflected by a higher AHI than those who refused CPAP treatment. A limited number of studies have examined interventions to improve CPAP use in older adults, including cognitive behavior therapy intervention, intensive support intervention and monthly home visits [35,36].…”

Intensiveversusstandard follow-up to improve continuous positive airway pressure compliance

“…Many psychological and educational interventions have been proposed as a means of increasing the hours of use of CPAP therapy. These interventions include education about the risks of OSAHS, outcome expectancies for CPAP treatment and CPAP self-efficacy; supportive measures, such as strategically timed follow-up appointments and telephone calls; and reinforcement of the patients' perception of the improvement in symptoms following CPAP therapy [7,8,12,14,16,[30][31][32][33][34][35][36][37][38].…”

Role of a Respiratory Therapist in Improving Adherence to Positive Airway Pressure Treatment in a Pediatric Sleep Apnea Clinic

“…15 Education about OSDB and PAP improved adherence in adults, including in subjects who had prior prolonged experience with PAP. [17][18][19] In children there have been few studies of PAP adherence. Behavioral interventions, including parent education and graded mask introduction, improve PAP adherence.…”