Sleep and Breathing

, Volume 17, Issue 4, pp 1229–1240

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
  • Romola S. Bucks
Original Article

DOI: 10.1007/s11325-013-0828-1

Cite this article as:
Skinner, T., McNeil, L., Olaithe, M. et al. Sleep Breath (2013) 17: 1229. doi:10.1007/s11325-013-0828-1

Abstract

Purpose

Obstructive sleep apnoea (OSA) is a common disorder, for which continuous positive airway pressure (CPAP) therapy is a standard treatment. Despite its well-established 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 Scale and 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.

Keywords

Belief-Based Illness Model CPAP uptake OSA Illness perceptions Psychology 

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Timothy Skinner
    • 1
  • Lindsay McNeil
    • 2
    • 3
  • Michelle Olaithe
    • 2
  • Peter Eastwood
    • 4
    • 5
  • David Hillman
    • 5
  • Janet Phang
    • 2
    • 7
  • Tamara de Regt
    • 2
    • 6
  • Romola S. Bucks
    • 2
  1. 1.Psychological and Clinical SciencesCharles Darwin UniversityDarwinAustralia
  2. 2.School of Psychology, Faculty of Life and Physical SciencesUniversity of Western AustraliaPerthAustralia
  3. 3.Child and Adolescent (Mental) Health ServicesPrincess Margaret HospitalPerthAustralia
  4. 4.Centre for Sleep Science, School of Anatomy, Physiology and Human BiologyThe University of Western AustraliaPerthAustralia
  5. 5.Department of Pulmonary Physiology and Sleep Medicine, Western Australian Sleep Disorders Research InstituteQueen Elizabeth II Medical CentrePerthAustralia
  6. 6.Royal Adelaide HospitalAdelaideAustralia
  7. 7.Singapore General HospitalSingaporeSingapore

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