According to a research abstract that will be presented on June 8, at Sleep 2009, the 23rd Annual Meeting of the Associated Professional Sleep Societies, active problem solving strategies are associated with successful use of continuous positive airway pressure (CPAP) therapy for the treatment of obstructive sleep apnea (OSA).
Results of the study indicate that certain coping strategies that are associated with CPAP success vary according to how "CPAP success" is defined. When success is defined as using therapy often enough for a sufficient amount of time each night, individuals who use active problem solving strategies are more likely to be successful. However, if success is defined as simply using therapy for a sufficient amount of time during the night then only goal-oriented problem solving and belief about personal control of behavior and emotions are related to success.
According to principal investigator Robert Glidewell, PsyD, CBSM, director of the sleep medicine and research program at the Lynn Institute of the Rockies in Colorado Springs, CO., CPAP initiation and education can be changed to improve the likelihood of successful outcomes. "Certain problem solving and coping styles are associated with more successful CPAP use than others," said Glidewell. "Individuals who use active problem solving strategies, such as seeking advice, information and feedback from people in their social network, generate goal-oriented schedules of action with specific tasks and who believe they are in control of their emotions and behaviors while solving problems or challenges are more likely to be successful with PAP than individuals who use other problem solving and coping styles or strategies."
With this in mind, authors of the study state patients must be informed that the process of adjusting to CPAP is likely to take between 30 and 90 days. Additionally, CPAP educators should focus on improving specific aspects of problem solving and coping, such as how to engage social and emotional support networks, how to access care providers and how to react to common CPAP related problems. In more challenging cases, a clinical psychologist or other clinician trained in behavioral sleep medicine should be involved in treatment.
The study included information from routine pre and post-treatment CPAP follow up in the clinic of a licensed psychologist certified in behavioral sleep medicine. Data were collected from 39 patients after seven days of treatment and from 19 patients after 30 days. Pretreatment standardized questionnaires concerning problem solving and coping styles were used to analyze the relationships between pretreatment questionnaire scores and adherence. Objective CPAP data use information was also collected.
Abstract Title: Differential Pretreatment Predictors of Initial and Long-Term CPAP Adherence
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