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Predicting uptake of continuous positive airway pressure (CPAP) therapy in Obstructive Sleep Apnoea (OSA): A belief-based theoretical approach
Journal article   Peer reviewed

Predicting uptake of continuous positive airway pressure (CPAP) therapy in Obstructive Sleep Apnoea (OSA): A belief-based theoretical approach

Timothy Skinner, Lindsay McNeil, Michelle Olaithe, Peter Eastwood, David Hillman, Janet Phang, Tamara De Regt and Romola S Bucks
Sleep and Breathing, Vol.17, pp.1229-1240
2013
url
https://doi.org/10.1007/s11325-013-0828-1View
Published Version

Abstract

Clinical Sciences Psychology belief-based illness model CPAP uptake OSA illness perceptions psychology
Abstract: Purpose Obstructive sleep apnoea (OSA) is a common disorder, for which continuous positive airway pressure (CPAP) therapy is a standard treatment. Despite its wellestablished efficacy, many patients choose not to initiate CPAP treatment. The present study investigated the degree to which biological measures (e.g. Apnoea-Hypopnoea Index [AHI]), symptom experiences (e.g. fatigue) and illness representations (e.g. perceived consequences) predict the decision of individuals newly diagnosed with OSA to undergo a trial of CPAP therapy. Methods Four hundred forty-nine individuals (316 males) newly diagnosed with OSA. Epworth sleepiness scale (ESS), Fatigue Severity Scale, Depression Anxiety Stress Scaleand Illness Perception Questionnaire-Revised (IPQ-R) were administered at time of sleep study. These, patient demographics and sleep study variables were used to determine factors predicting patient decision to proceed with a trial of CPAP. Results The participants were most likely to attribute their OSA to unchangeable and psychological factors. For those with moderate OSA (AHI, 15 to 30) IPQ-R illness consequence was predictive of decision to initiate CPAP (p = 0. 002). For severe OSA (AHI >30) age, ESS and IPQ illness causal beliefs were predictive of decision to initiate CPAP (p < 0.001). Conclusions Illness beliefs are important determinants of the choice of recently diagnosed OSA patients whether or not to undertake a trial of CPAP therapy. Concerns about illness consequences were important in those with moderate OSA. In severe OSA, sleepiness symptoms are more prominent and a more significant determinant of CPAP uptake along with age and causal beliefs.

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Clinical Neurology
Respiratory System

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