Spousal Involvement in CPAP: Does Pressure Help?

Abstract

Study Objectives: Continuous positive airway pressure (CPAP) improves sleep and quality of life for both patients with obstructive sleep apnea (OSA) and their spouses. However, few studies have investigated spousal involvement in treatment adherence. Aims of this observational study were to assess perceptions of spousal involvement and evaluate associations between involvement and adherence. Methods: Spousal involvement in CPAP adherence was assessed in 23 married male OSA patients after the fi rst week of treatment. At 3 months, 16 participants completed a second assessment of spousal involvement. Types of involvement assessed included positive (e.g., encouraging), negative (e.g., blaming), collaboration (e.g., working together), and onesided (e.g., asking). An interpersonal measure of supportive behaviors was also administered at 3 months to evaluate the interpersonal qualities of spousal involvement types. Objective CPAP adherence data were available for 14 participants. Results: Average frequency of spousal involvement ratings were low for each involvement type and only negative spousal involvement frequency decreased at 3 month follow-up (p = 0.003). Perceptions of collaborative spousal involvement were associated with higher CPAP adherence at 3 months (r = 0.75, p = 0.002). Positive, negative and one-sided involvement were not associated with adherence. Collaborative spousal involvement was associated with moderately warm and controlling interpersonal behaviors (affi liation, r = 0.55, p = 0.03, dominance r = 0.47, p = 0.07). Conclusions: Patients reported low frequency but consistent and diverse perceptions of spousal involvement in CPAP over the fi rst 3 months of treatment. Perceptions of collaborative spousal involvement were the only type associated with adherence and represent moderately warm and controlling interpersonal behavior. Interventions to increase spousal collaboration in CPAP may improve adherence. keywords: Obstructive sleep apnea, continuous positive airway pressure, adherence, relationship quality, social support Citation: Baron KG; Gunn HE; Czajkowski LA; Smith TW; Jones CR. Spousal involvement in CPAP: does pressure help?

A Brief Survey of Patients' First Impression after CPAP Titration Predicts Future CPAP Adherence: A Pilot Study

“…[17][18][19] Certain factors have already been associated with poor adherence to CPAP therapy: lack of sleep specialist consultation prior to polysomnogram (PSG), 20,21 African American race, 20,22 low socioeconomic status, [23][24][25] reduced nasal airway caliber, 26 and mask leak, 27 to name a few. Social factors, such as living with another person, 28 spousal involvement, 29 and participation in educational support groups 30 are associated with improved CPAP adherence. Other factors, including OSA severity, body tionnaires [33][34][35][36] and serial assessments, 37 which are useful in a research model but may not be practical in a clinical setting.…”

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

“…A closer assessment of spousal involvement (i.e., collaborative, one-sided, positive, and negative) during the first 3 mo of CPAP treatment in 23 male patients with OSA revealed both positive (e.g., changed something at work or home to get me to use CPAP) and negative (e.g., tried to make me scared of the consequences of not using CPAP) involvement of wives approximately one to two times during the first week of treatment. 43 Frequency of perceived spousal involvement remained the same at 3-mo follow-up except for negative involvement, which had decreased. Perceived collaborative spousal involvement was associated with greater CPAP adherence at 3 mo.…”

“…Limited studies suggest partner involvement that is collaborative and supportive is an important facilitator of CPAP use. [42][43][44] Other than two qualitative studies, 13,46 assessment of partner involvement has primarily been from the patients' perspective. Future research needs to take into consideration the dyadic nature of partner involvement and measure spousal involvement independently in both patients and partners as actual and perceived FS Luyster.…”

“…Adoption of a collaborative approach to improving CPAP adherence may be a beneficial strategy for interventions promoting CPAP adherence. 42,43 This review reveals the many opportunities for developing future studies to better understand the impact of OSA and OSA treatments on partners and partners' role in OSA treatment adherence. Longitudinal studies with assessments from both patients and partners will enable evaluation of interactive effects of health outcomes associated with OSA and its treatments.…”

Relationships and CPAP adherence among women with obstructive sleep apnea

“…Our results suggest that increasing helpful spousal involvement may be helpful for both men and women. We previously reported that collaborative involvement and support were associated with higher adherence (Baron et al 2011(Baron et al , 2012. To date only one intervention has specifically involved spouses (Hoy et al 1999) and found that increasing helpful involvement was one part of a successful intervention.…”