Relationship quality and CPAP adherence in patients with obstructive sleep apnea.
ABSTRACT The prospective influence of relationship support and conflict on adherence to continuous positive airway pressure (CPAP) was examined over the first 3 months of CPAP treatment in 42 married, male patients with obstructive sleep apnea (OSA). CPAP adherence reports were available for 23 patients. Patient ratings of marital conflict predicted average nightly adherence (beta = -0.357, p < .05), but ratings of marital support did not predict adherence. Three-month follow-up ratings of marital support and conflict, subjective sleepiness, depression, and functional impairment were available for 16 patients from the first sample. Six additional patients without adherence reports provided baseline and 3-month follow-up questionnaire data, which resulted in a total of 22 patients with follow-up questionnaire data. Following 3 months of CPAP, patients reported decreased marital conflict (d = 0.43, p < .05), sleepiness (d = 1.13, p < .001), depression (d = 0.73, p < .001), and functional impairment (d = 1.48, p < .001). These findings highlight the importance of evaluating marital conflict for OSA patients and suggest marital conflict may be a target for interventions to improve CPAP adherence.
SourceAvailable from: Patrick J Strollo[Show abstract] [Hide abstract]
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.Behavioral Sleep Medicine 09/2014; DOI:10.1080/15402002.2014.946597 · 1.56 Impact Factor
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ABSTRACT: Poor adherence to continuous positive airway pressure (CPAP) treatment is associated with substantial health care costs, morbidity and mortality, and has been a leading obstacle in the effective management of obstructive sleep apnea (OSA). Successful interventions to improve CPAP adherence may ultimately include a variety of components. For patients living with spouses (refers to all domestic partners), the spouse will likely be an integral component to any successful intervention. Developing understanding of the role of spouses in adherence to CPAP has been identified to be a critical research need. This review expands the investigation of CPAP adherence to a broader context, from an exclusive focus on individual patients to a dyadic perspective encompassing both patients and their spouses. A conceptual framework based on social support and social control theories is proposed to understand spousal involvement in CPAP adherence. Methodologies for future investigations are discussed, along with implications for developing interventions that engage both patients and their spouses to improve CPAP use.Sleep Medicine Reviews 05/2014; DOI:10.1016/j.smrv.2014.04.005 · 9.14 Impact Factor
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ABSTRACT: Although there is substantial evidence linking marital quality to physical health, few studies have been longitudinal. This study examined data from the Marital Instability Over the Life Course Study; 1,681 married individuals followed for 20 years were included in these analyses. In order to control for life course effects, participants were divided into 2 cohorts: early life and midlife. On the basis of latent growth curve analysis, the results indicated that initial values of marital happiness and marital problems were significantly associated with the initial value of physical health among both cohorts. In addition, the slope of marital happiness was significantly associated with the slope of physical health among the younger cohort, and the slope of marital problems was significantly associated with the slope of physical health among the midlife cohort. These results provide evidence of the significant association between positive and negative dimensions of marital quality and physical health over the life course.Journal of Marriage and Family 06/2013; 75(3). DOI:10.1111/jomf.12025 · 3.01 Impact Factor