Relationships and CPAP adherence among women with obstructive sleep apnea

Kelly Glazer Baron,Heather E Gunn,Phyllis C Zee,Lisa F Wolfe

doi:10.1186/s41606-017-0011-x

Abstract

BackgroundObstructive sleep apnea contributes to daytime sleepiness, poor quality of life and increased risk for heart disease and hypertension among women. Continuous positive airway pressure improves sleepiness and quality of life and may reduce health risks but few studies have evaluated predictors of adherence among women. The goal of this study was to evaluate the role of relationship factors in women’s continuous positive airway pressure (CPAP) adherence and change in relationship quality among married/partnered women.MethodsWomen recently diagnosed with obstructive sleep apnea completed relationship quality, social support questionnaires and spousal involvement interviews. CPAP adherence was collected at 12 weeks.ResultsData were available for 16 women. Average CPAP adherence was 3.6 SD = 2.7 h per night. Women with higher reports of social support had higher adherence. None of the unmarried/partnered participants were adherent to the recommendation of CPAP use ≥ 4 h per night at 12 week follow-up. Marital status was not associated with demographic, disease severity or social support measures. Relationship conflict among married/partnered participants was associated with lower adherence. In qualitative surveys, encouragement and support were the two most commonly reported types of partner involvement. Relationship quality did not change between baseline and 3 months.ConclusionResults suggest relationship factors are robust predictors of CPAP adherence among women with obstructive sleep apnea.

Highlights

Obstructive sleep apnea contributes to daytime sleepiness, poor quality of life and increased risk for heart disease and hypertension among women
We previously reported in a study of male patients with OSA, higher relationship conflict was associated with poorer adherence and collaborative spousal involvement by the spouse was associated with greater continuous positive airway pressure (CPAP) adherence (Baron et al 2011; Baron KG 2008)
Three participants declined CPAP treatment and data from one participant was removed from the analyses due to

Summary

Introduction

Obstructive sleep apnea contributes to daytime sleepiness, poor quality of life and increased risk for heart disease and hypertension among women. Continuous positive airway pressure improves sleepiness and quality of life and may reduce health risks but few studies have evaluated predictors of adherence among women. The goal of this study was to evaluate the role of relationship factors in women’s continuous positive airway pressure (CPAP) adherence and change in relationship quality among married/partnered women. Despite the benefits of continuous positive airway pressure (CPAP) for health and quality of life, 46–83% of OSA patients are non-adherent A recent study found that being married was associated with higher adherence in a sample of both women and men (Gagnadoux et al 2011) These studies did not take into account relationship quality or they ways in which spouses were involved. Given that women are more physically and emotionally reactive to relationship conflict (Kiecolt-Glaser and Newton 2001) and both marital status and relationship quality have been associated with women’s sleep quality (Gallo et al 2003)

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