Patient and Partner Experiences With Obstructive Sleep Apnea and CPAP Treatment: A Qualitative Analysis

Abstract

Few studies have investigated factors associated with continuous positive airway pressure (CPAP) treatment for sleep apnea from the patients’ and their partners’ perspective. This qualitative research study explored patients’ and partners’ experiences of CPAP and facilitators and barriers to CPAP use, and elicited suggestions for a first-time CPAP user program. Data from 27 participants were collected via four sleep apnea patient and four partner focus groups. Qualitative content analysis identified five themes: knowledge of sleep apnea, effects of sleep apnea, effects of CPAP, barriers and facilitators of CPAP, and ideas for a new user support program. Patients and partners emphasized the importance of partner involvement in the early CPAP treatment period. These data suggest consideration of a couple-oriented approach to improving CPAP adherence.

Impact of Obstructive Sleep Apnea and Its Treatments on Partners: A Literature Review

“…25 During focus groups conducted with spouses of patients with OSA managed with CPAP, partners described the experience of not hearing their partner snore during the first few nights with CPAP as alarming; however, after adjusting to this new occurrence, partners noted being able to fall asleep faster, having more energy, being happier, and resuming bed sharing. 13 Studies examining the effect of CPAP treatment on marital satisfaction based on partners' report yield conflicting results. In a prospective trial of CPAP treatment versus conservative treatment (i.e., weight loss, sleeping posture, and avoidance of alcohol in the evening), 44 partners completed questionnaires about marital satisfaction before and 3 mo after treatment initiation.…”

“…11 Qualitative data reveal that partners are distressed by witnessing patients' apneas and feel a need to monitor the patient's breathing during the night to ensure he/she continues to breathe. 12,13 Studies utilizing PSG to assess sleep among partners of patients with untreated OSA also have found significant sleep disturbances. [14][15][16] In an early study, 10 wives of husbands undergoing PSG for suspected OSA underwent concurrent PSG in the same bed as their husbands.…”

“…Similarly, partners identified providing emotional support (e.g., encouragement) and instrumental support (e.g., verbal reminders, help with putting on mask) as motivators for the patient to use CPAP during focus group discussions. 13 During semistructured interviews with patients with OSA, unmarried patients described an absence of support, less belief in their ability to use CPAP, and fewer positive experiences with CPAP after the first week of treatment compared to married patients. 45 Elfström et al conducted semistructured interviews with 25 partners of patients with CPAP-treated OSA to learn about situations influencing partners' support to patients and strategies for managing these situations during the initial phase of CPAP treatment.…”

“…12 Partners' sleep loss often resulted in frustration, exhaustion, interference with work, and a strained relationship. 13 In an early study, marital dissatisfaction, in particular conflict over childrearing, was reported by wives of OSA patients. 17 Virkkula et al found 35% of partners of men with suspected OSA (n = 37) reported relationship problems due to snoring.…”

“…10,13 For some couples, patients' snoring and its interference with partners' sleep lead to sleeping in separate rooms. 12,13,17 Others may insist on maintaining bed sharing despite disturbed sleep in order to avoid social stigma and to maintain the feeling of a "healthy" relationship. 12 Partners' sleep loss often resulted in frustration, exhaustion, interference with work, and a strained relationship.…”