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A pathway underlying the impact of CPAP adherence on intimate relationship with bed partner in men with obstructive sleep apnea

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Our aim was to determine the pathway underlying the effects of continuous positive airway pressure (CPAP) adherence on intimate relationship with bed partner in men with obstructive sleep apnea (OSA). We hypothesized that CPAP with good adherence affected the intimate relationship with bed partner directly and indirectly, and it was mediated through daytime sleepiness and activity level in men with OSA.

Methods

Data were obtained from an education program for enhancing CPAP adherence. Men who were newly diagnosed of OSA and CPAP therapy naïve were recruited in a tertiary teaching hospital.

Results

Self-reported quality of life [Functional Outcomes of Sleep Questionnaire], daytime sleepiness [Epworth Sleepiness Scale (ESS)], and negative emotion symptoms [depression, anxiety, stress scale] were assessed before and after CPAP treatment at 1-year assessment. Seventy-three men were included in the data analysis, with a mean ± SD age of 52 ± 10 years, body mass index of 29.0 ± 5.2 kg/m2, ESS of 9.5 ± 5.6, and median [interquartile range(IR)] apnea and hypopnea index of 31 (21, 56) events/h. The median (IR) CPAP daily usage was 4.3(0, 6.1) h/day. From the path analysis, CPAP therapy was shown to improve intimate relationship directly (ß = 0.185) and indirectly (ß = 0.050) by reducing daytime sleepiness and increasing activity level. However, negative emotion symptoms were not the mediators between CPAP adherence and the intimate relationship.

Conclusions

CPAP therapy with good adherence is related directly and indirectly to a better intimate relationship with bed partner in men with OSA. It was possibly attributed to reduced daytime sleepiness and increased activity level.

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Acknowledgments

The authors would like to give special thanks to Ms. Michelle Cheong for her technical support in CPAP mask fitting and machine issuing and to Ms. Kaiser Sung, Ms. Eppie Sin, Ms. Po-Yee Chu, and the staff of Ho Ting Sik Sleep Disorders Centre, Queen Mary Hospital, for data collection. This study was supported by a grant award from the Health Services Research Committee, Hong Kong.

Conflict of interest

This was not an industry-supported study. Dr. Ip has received honoraria from Philips Respironics, Inc. for a lecture in Worldsleep 2011 and a lecture at Kyoto University in 2011. Dr. Weaver is the member of the board of directors of ViMedicus, Inc. She has received research support from TEVA, Inc. and has received equipment for her research from Philips Respironics, Inc. She has been a consultant for Apnex Medical, Inc, and has received royalty fees for use of the Functional Outcomes of Sleep Questionnaire from Nova Som, Apnex Medical, Inc., GlaxoSmithKline, Philips Respironics, Inc., Cephalon, Inc., and Nova Nordsk. Dr. Lam has been sponsored to attend Worldsleep conference 2011, World Congress of Sleep Apnea 2012, Sleep and Breathing conference 2013 by ResMed, Philips Respironics, Inc., and Homecare Medical Ltd., respectively. Dr Lai has been sponsored to attend the Sleep and Breathing conference 2013 and 18th Congress of the Asian Pacific Society of Respirology by ResMed and Philips Respironics, Inc., respectively. Dr. Fong indicated no financial conflicts of interests.

Compliance with ethical standards

All procedures performed in this study involving human participants were in accordance with ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards

Author contributions

Dr. Lai has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr. Lai contributed to the study concept and design; acquisition, analysis, and interpretation of data; and drafting and critical revision of the manuscript for important intellectual content. Dr Ip contributed to the study concept and design, interpretation of data, critical revision of the manuscript for important intellectual content, and administrative support. Dr. Weaver contributed to the interpretation of data and critical revision of the manuscript for important intellectual content. Dr. Lam contributed to the study concept and design, interpretation of data, critical revision of the manuscript for important intellectual content, and administrative support. Dr. Fong contributed to the study concept and design, interpretation of data, and critical revision of the manuscript for important intellectual content.

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Authors and Affiliations

  1. Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, SAR, China

    Agnes Y. K. Lai, Mary S. M. Ip & Jamie C. M. Lam

  2. Research Centre of Heart, Brain, Hormone and Healthy Aging, The University of Hong Kong, Hong Kong, SAR, China

    Mary S. M. Ip

  3. College of Nursing, University of Illinois at Chicago, Chicago, IL, USA

    Terri E. Weaver

  4. School of Nursing, The University of Hong Kong, Hong Kong, SAR, China

    Daniel Y. T. Fong

Authors
  1. Agnes Y. K. Lai
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  2. Mary S. M. Ip
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  3. Jamie C. M. Lam
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  4. Terri E. Weaver
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  5. Daniel Y. T. Fong
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Corresponding author

Correspondence to Agnes Y. K. Lai.

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Lai, A.Y.K., Ip, M.S.M., Lam, J.C.M. et al. A pathway underlying the impact of CPAP adherence on intimate relationship with bed partner in men with obstructive sleep apnea. Sleep Breath 20, 543–551 (2016). https://doi.org/10.1007/s11325-015-1235-6

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  • DOI: https://doi.org/10.1007/s11325-015-1235-6

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