Researchers from Penn State University School of Nursing have recently completed a study that provides helpful information for physicians hoping to help patients with adherence to the use of continuous positive airway pressure therapy, or CPAP.
CPAP is one of the most effective treatments available for the treatment of obstructive sleep apnea, a serious health condition that causes sufferers to stop breathing multiple times during the night. Obstructive sleep apnea (OSA) is an increasing problem in American society, particularly as the population ages and the obesity epidemic continues to spread. OSA is more likely to be diagnosed in older adults and those who are overweight; it is caused by the tissue and muscles of the airway collapsing on itself when the patient is sleeping, restricting air from reaching the brain.
In cases of severe OSA patients may stop breathing over fifty times per hour while completely unaware that it is happening. This puts tremendous stress on the body’s cardiovascular system and increases the risk of a number of serious medical complications; it also robs the patient of quality sleep. CPAP sends a continuous flow of air into the airway, forcing it to remain open. The problem with the therapy is that the equipment that is required can be cumbersome to wear while sleeping, and people are prone to abandon its use when it becomes uncomfortable or arduous to wear. Researchers are trying to determine what makes a patient more likely to be compliant, and the results of the Penn State study may be helpful in that regard.
According to principal investigator Amy M. Sawyer, PhD, RN and assistant professor at Penn State University School of Nursing, their research determined that people who were more likely to utilize the equipment were those who had a regular bedtime routine prior to beginning its use. “Long-term use of PAP, such as after the first month or longer, requires regular routines that are conducive to establishing a new health behavior.” The study had followed 97 adult patients who had been recently diagnosed with OSA. The patients were asked to take notes in a sleep diary for a week prior to beginning the use of the equipment. Adherence to the equipment was measured objectively from data collected from the device itself.
The results yielded a clear pattern that showed that those who had a previously established habit of having a regular bedtime were significantly more likely to use the equipment with regularity and to continue its use. Noncompliance had a 3.7 times greater chance of being a problem for every unit of variability in bedtime routine as indicated by the sleep journal entries.
According to Sawyer, “Our results suggest that CPAP use is associated with stable bedtime schedules. By stabilizing bedtime schedules or promoting consistency in bedtime patterns and routines prior to initiating CPAP treatment, adherence may improve.”