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BookmarkScienceDaily (July 21, 2008) — A study by QUT sleep psychologists is shedding light on why some people with life-threatening conditions do not adhere to medical treatment, even when "it's for their own good".
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Dr Simon Smith, from Queensland University of Technology's Centre for Accident Research & Road Safety - Queensland (CARRS-Q), studied people newly diagnosed with obstructive sleep apnoea (OSA) and found they were more likely to take up, and stick to, treatment when they believed they could do so, regardless of how severe their condition was.
OSA is a serious condition in which sufferers stop breathing throughout the night, only starting to breathe again when their brain registers lack of oxygen and wakes them up.
OSA causes sufferers to fall asleep during the day or at the wheel of their car, puts a strain on their hearts which can lead to heart attack and stroke, and has been linked to Type-II diabetes.
The treatment is to wear a mask at night attached to a machine that keeps the airway open and maintains normal breathing. Losing weight through diet and exercise can also have a significant effect in reducing the symptoms and can even do away with the need for the mask.
"From other research we know between 15 and 20 per cent of people diagnosed with OSA won't accept treatment at all. Of those who start treatment, up to 50 per cent don't use it enough, that is right through the night, or they give up using it," Dr Smith said.
He found psychological factors had a powerful effect on whether people would accept effective medical treatment.
"Surprisingly, people with the most serious disease aren't any more likely to stick to the treatment.
"We found a person's beliefs about the treatment's effectiveness, their confidence in sticking to the treatment, and their understanding of the condition's health risks, were more important than the severity of the disease."
Dr Smith said it was often only the urging of family and friends that caused OSA sufferers to see a doctor because the cost to their health, like other chronic diseases, might be some way down the track.
"A person with OSA might fall asleep during the day, but if they aren't working or don't drive much, this might not worry them enough to seek treatment or stick to treatment.
"But if a spouse or family members pressure them to do something about the loud stop-start snoring that accompanies OSA, which is keeping them awake, the sufferer is more likely to do something about it.
"After they have seen the doctor and been offered treatment, psychological factors, including the threat to important relationships, are what motivates them into complying with treatment."
Dr Smith said the research would lead to new programs to get people motivated to change their health behaviours, and help them to adhere to treatments that would alleviate chronic health conditions.
