The Abstracts of the 13th Annual Conference of the APS College of Clinical Neuropsychologists

Abstract

Continuous Positive Airway Pressure (CPAP) is an effective therapy for Obstructive Sleep Apnoea (OSA), but adherence is poor. This study tested a motivational model of adherence at 3 months post-treatment initiation. 77 consecutive patients (61% male) newly diagnosed with OSA completed questionnaires assessing; outcome expectancy with treatment, self-efficacy, functional outcomes of sleepiness, and perceived risk of negative health outcomes. Physiological data from a standard clinical diagnostic sleep study were obtained. Average objective adherence to CPAP was 4.57 hours per night. Physiological indices correlated with adherence in the opposite direction to that expected. Fewer oxygen dips and fewer arousals before treatment were associated with greater adherence at 3 months. In a hierarchical regression, these physiological variables did not explain significant portions of the variance in CPAP adherence (10.4%, p>.05), whilst treatment outcome expectancies and functional outcomes of sleep explained a unique proportion of the variance (15.3%, p<.05), and in combination with physiological variables explained 32% of the total variance in CPAP adherence (p<.01). The implications of the physiological findings in terms of hypoxic events, cognition and subsequent adherence will be discussed. An intervention for targeting functional outcomes of sleepiness and outcome expectancies to increase patients’ adherence to treatment will be outlined.