Predicting uptake of continuous positive airway pressure (CPAP) therapy in obstructive sleep apnoea (OSA): A belief-based theoretical approach

Timothy Skinner, Lindsay McNeil, Michelle Olaithe, Peter Eastwood, David Hillman, Janet Phang, Tamara De Regt, Romola S. Bucks

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Purpose: Obstructive sleep apnoea (OSA) is a common disorder, for which continuous positive airway pressure (CPAP) therapy is a standard treatment. Despite its well-established efficacy, many patients choose not to initiate CPAP treatment. The present study investigated the degree to which biological measures (e.g. Apnoea-Hypopnoea Index [AHI]), symptom experiences (e.g. fatigue) and illness representations (e.g. perceived consequences) predict the decision of individuals newly diagnosed with OSA to undergo a trial of CPAP therapy. Methods: Four hundred forty-nine individuals (316 males) newly diagnosed with OSA. Epworth sleepiness scale (ESS), Fatigue Severity Scale, Depression Anxiety Stress Scale and Illness Perception Questionnaire-Revised (IPQ-R) were administered at time of sleep study. These, patient demographics and sleep study variables were used to determine factors predicting patient decision to proceed with a trial of CPAP. Results: The participants were most likely to attribute their OSA to unchangeable and psychological factors. For those with moderate OSA (AHI, 15 to 30) IPQ-R illness consequence was predictive of decision to initiate CPAP (p = 0.002). For severe OSA (AHI >30) age, ESS and IPQ illness causal beliefs were predictive of decision to initiate CPAP (p < 0.001). Conclusions: Illness beliefs are important determinants of the choice of recently diagnosed OSA patients whether or not to undertake a trial of CPAP therapy. Concerns about illness consequences were important in those with moderate OSA. In severe OSA, sleepiness symptoms are more prominent and a more significant determinant of CPAP uptake along with age and causal beliefs.

Original languageEnglish
Pages (from-to)1229-1240
Number of pages12
JournalSleep and Breathing
Volume17
Issue number4
DOIs
Publication statusPublished - Dec 2013
Externally publishedYes

Bibliographical note

Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.

Keywords

  • Belief-Based Illness Model
  • CPAP uptake
  • Illness perceptions
  • OSA
  • Psychology

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