HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Wild, M.R. Articles by Espie, C.A. Search for Related Content PubMed PubMed Citation Articles by Wild, M.R. Articles by Espie, C.A.

Can psychological factors help us to determine adherence to CPAP? A prospective study

¹ Section of Psychological Medicine, University of Glasgow, and ² Edinburgh Sleep Centre, Dept of Respiratory Medicine, University of Edinburgh, UK

CORRESPONDENCE: M. Wild, Section of Psychological Medicine, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, UK. Fax: 44 1413574899. E-mail: m.wild@clinmed.gla.ac.uk

Keywords: Patient compliance, positive pressure ventilation, sleep apnoea syndromes

Received: October 14, 2003
Accepted April 26, 2004

The present study objective was to establish whether pretreatment social cognitive variables may contribute to the explanation of variance in adherence to continuous positive airway pressure (CPAP) treatment for patients with obstructive sleep apnoea/hypopnoea syndrome (OSAHS).

A total of 119 of 180 consecutive OSAHS patients were recruited to the study prior to initial CPAP titration. Patients completed psychological measures of health value, health locus of control (incorporating internality, chance, powerful others) and self-efficacy prior to CPAP titration. Objective adherence data were measured by CPAP unit time clocks and collected at 3-month follow-up. Average nightly use was calculated over this period.

Logistic regression of prospective predictors of adherence produced a model comprising psychological (health value, internality, powerful others), as well as clinical variables (Epworth score, body mass index, apnoea/hypopnoea index, CPAP pressure). This model explained 24% of the variance in CPAP use, and correctly identified 75% of adherers and 53% of nonadherers.

Although the psychological variables explained only a small amount of the overall variance in adherence behaviour, this result provides further support for the hypothesis that psychological variables contribute, in part, to continuous positive airway pressure adherence. Future research should focus on highlighting discrete variables, which may helpfully inform psychologically based interventions aimed at improving the use of continuous positive airway pressure by patients with obstructive sleep apnoea/hypopnoea syndrome at risk of discontinuance.

This article has been cited by other articles:

				J. Collen, C. Lettieri, W. Kelly, and S. Roop Clinical and Polysomnographic Predictors of Short-Term Continuous Positive Airway Pressure Compliance Chest, March 1, 2009; 135(3): 704 - 709. [Abstract] [Full Text] [PDF]

				S. Olsen, S. Smith, T. Oei, and J. Douglas Health belief model predicts adherence to CPAP before experience with CPAP Eur. Respir. J., September 1, 2008; 32(3): 710 - 717. [Abstract] [Full Text] [PDF]

				T. E. Weaver and R. R. Grunstein Adherence to Continuous Positive Airway Pressure Therapy: The Challenge to Effective Treatment Proceedings of the ATS, February 15, 2008; 5(2): 173 - 178. [Abstract] [Full Text] [PDF]