A randomized controlled trial of a multi-dimensional intervention to improve CPAP use and self-efficacy

Objectives: To assess the utility of a tailored intervention program to improve continuous positive airway pressure (CPAP) use and self-efficacy in individuals with obstructive sleep apnea (OSA).Methods: 81 participants (mean age 52.1 & PLUSMN; 11.6 years; 35 females) with OSA were randomized to either a multi-dimensional intervention (PSY CPAP, n = 38) or treatment as usual (TAU CPAP, n = 43). The intervention included a psychoeducation session prior to CPAP initiation, a booster psychoeducation session in the first weeks of commencing CPAP, follow-up phone calls on days 1 and 7, and a review appointment on day 14. CPAP use was compared between the PSY CPAP and TAU CPAP groups at 1 week, 1 month, and 4 months. Self-efficacy scores (risk perception, outcome expectancies, and CPAP self-efficacy) were compared between groups following the initial psychoeducation session and again at 1 month and 4 months.Results: CPAP use was higher in the PSY CPAP group compared to the TAU CPAP group for all time points (p = .02). Outcome expectancies improved significantly over time in PSY CPAP participants (p = .007). Change in risk perception was associated with CPAP use at 1 week (p = .02) for PSY CPAP participants. However, risk perception did not mediate the effect between group and CPAP use at 1 week. Conclusions: Interventions designed to increase self-efficacy and administered prior to CPAP initiation, repeated in the early stages of CPAP therapy, and combined with a comprehensive follow-up regime are likely to improve CPAP use. Sustained improvement in CPAP use is the ultimate goal but remains to be investigated.

Automated summary

This study assessed the effectiveness of a tailored intervention program in improving CPAP use and self-efficacy in individuals with OSA. The results found that the intervention group had significantly higher CPAP usage rates compared to the control group, indicating improved treatment outcomes. Therefore, providing psychoeducation prior to CPAP initiation, supplemented with additional sessions during the early stages of therapy, and combined with thorough follow-up, can enhance CPAP utilization.