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Spousal involvement in CPAP adherence among patients with obstructive sleep apnea

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Abstract

Purpose

To determine the effects of spousal involvement on continuous positive airway pressure (CPAP) adherence and response to CPAP problems in male patients with obstructive sleep apnea (OSA).

Methods

Wives’ involvement (pressure, support, and collaboration), CPAP adherence and CPAP problems (e.g., mask leaks) were assessed for 10 days in 31 male OSA patients. Disease severity and pre-treatment ratings of relationship quality were tested as moderators of daily associations in multilevel models. Effects of wives’ involvement were tested as predictors of day-to-day adherence and average nightly adherence at 3 months.

Results

Perception of wives’ support predicted increased adherence only in patients with high disease severity. Collaboration increased following nights with lower adherence and greater CPAP problems. Patients with lower conflict in the relationship reported a greater increase in collaboration associated with CPAP problems. Patients with lower support in the relationship reported increased next-day support following nights with CPAP problems. Perceived pressure from the wife was not associated with increased adherence in day-to-day analyses and associated with poorer adherence at 3 months.

Conclusions

The relationship between wives’ involvement and adherence was bidirectional and influenced by disease and relationship context. The majority of findings demonstrated increased positive wife involvement as a reaction to adherence and problems with CPAP. Supportive and collaborative interventions have the potential to improve CPAP adherence and response to CPAP-related problems, particularly in patients with high disease severity. Pressure to use CPAP from the wife was not beneficial for adherence that day and predicted poorer adherence at 3 months. Further research is needed to test supportive spousal involvement as an adherence intervention.

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Authors and Affiliations

  1. Department of Neurology, Northwestern University, 710 Lakeshore Drive, 5th Floor, Chicago, IL, 60611, USA

    Kelly Glazer Baron & Heather Gunn

  2. Department of Psychology, University of Utah, Salt Lake, UT, USA

    Timothy W. Smith & Cynthia A. Berg

  3. Department of Psychiatry, University of Utah, Salt Lake, UT, USA

    Laura A. Czajkowski

  4. Department of Neurology, University of Utah, Salt Lake, UT, USA

    Christopher R. Jones

Authors
  1. Kelly Glazer Baron
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  2. Timothy W. Smith
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  3. Cynthia A. Berg
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  4. Laura A. Czajkowski
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  5. Heather Gunn
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  6. Christopher R. Jones
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Correspondence to Kelly Glazer Baron.

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Authors note

This study was funded in part by an APA Division 38 Health Psychology graduate student research award and by the University of Utah Sleep Wake Center. The authors thank the physicians and staff at the University of Utah Sleep Wake Center for their assistance in data collection, including Dr. Robert Simpson, Rick Pointer, and Thi-ly Downing.

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Baron, K.G., Smith, T.W., Berg, C.A. et al. Spousal involvement in CPAP adherence among patients with obstructive sleep apnea. Sleep Breath 15, 525–534 (2011). https://doi.org/10.1007/s11325-010-0374-z

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  • DOI: https://doi.org/10.1007/s11325-010-0374-z

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