Journal of Sleep Disorders & Therapy
Open Access

Abstract

Interventions to Improve CPAP Adherence and Outcomes: Role of Theory and Behavioral Change Techniques

Carl Stepnowsky, Tania Zamora, Christine Edwards, Lin Liu and Zia Agha

Study Background: Low patient adherence to nasal Continuous Positive Airway Pressure (CPAP) limits treatment effectiveness. A wide variety of CPAP adherence intervention studies have been performed to date, with many showing some improvement in CPAP adherence. Better understanding of the theoretical foundations, specific behavioral change techniques, and modes of intervention delivery can help provide guidance for future interventional efforts and reflects efforts underway in the general treatment adherence literature.

Methods: The CPAP adherence literature was reviewed to identify those studies that included a specific intervention designed to increase CPAP use. Twenty-nine studies were included in this review. Published coding schemes were used.

Results: The average effect size of the CPAP adherence interventions in adults who are new users of CPAP was 0.52 (SD=0.42, range: 0-1.52). This moderate effect size did not appear to be related to the number of behavioral change techniques, use of theory, or to mode of delivery. Conclusion: Future research efforts should build on previous interventional studies, with the ultimate goal of identifying those techniques that can help improve CPAP adherence and patient outcomes