Megan Brooks

June 04, 2014

MINNEAPOLIS — Adults with obstructive sleep apnea (OSA) who are single or have unsupportive family relationships are at risk for poor adherence to continuous positive airway pressure (CPAP) therapy, a new study hints. 

"This is the first study to explore the role of family factors in CPAP adherence," lead investigator Faith Luyster, PhD, research assistant professor in the School of Nursing at the University of Pittsburgh, Pennsylvania, said in a statement. 

Her study suggests that having a spouse or partner, or having healthy relationships with family members, can create an environment that supports the patient's use of CPAP.

"Family-based CPAP adherence interventions may be helpful" in the early period of CPAP therapy, Dr. Luyster told Medscape Medical News.  

She presented the study here June 2 at SLEEP 2014, the 28th annual meeting of the Associated Professional Sleep Societies.

Effective Treatment, Poor Compliance

According to the American Academy of Sleep Medicine, OSA affects up to 7% of men and 5% of women. CPAP is the most effective treatment option, but compliance is often poor.

Until now, it was unclear to what extent relationships influence CPAP adherence; the few available studies have focused almost exclusively on married men.

Dr. Luyster's study involved 253 patients (39% women) with OSA who were participating in a CPAP adherence intervention study. Relationship status at baseline was identified, and quality of family relationships was assessed by using the 12-item General Functioning subscale of the Family Assessment Device. Treatment adherence was measured objectively and was defined as average hours of CPAP use per night.

After adjustment for potential confounding factors, including age, sex, and body mass index, individuals who were married or living with a partner had better CPAP adherence after the first 3 months of treatment than those who were single (P < .01).  

Higher ratings of family relationship quality also were associated with better adherence (P < .05).  Older age was also associated with better adherence to CPAP at 3 months (P < .01).

The finding "makes sense," Dr. Luyster said. "CPAP is a unique and awkward treatment. It's not just taking a pill, and having a team behind you is really important for encouragement, for actually helping put on the mask and for the cleaning that is involved."

   "This study is interesting and not surprising," Clete Kushida, MD, PhD, professor and medical director of the Stanford Sleep Medicine Center in Palo Alto, California, and past president of the American Academy of Sleep Medicine, told Medscape Medical News. "Family support is an independent factor that has been shown to increase adherence," he noted.

The study was supported by grants from the National Heart Lung and Blood Institute. Dr. Luyster and Dr. Kushida have disclosed no relevant financial relationships.

SLEEP 2014: 28th Annual Meeting of the Associated Professional Sleep Societies. Abstract 0346. Presented June 2, 2014.  

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