Department of Neurology, Northwestern University, Chicago, IL, USA.
Sleep Breath. 2011 Sep;15(3):525-34. doi: 10.1007/s11325-010-0374-z. Epub 2010 Jun 15.
To determine the effects of spousal involvement on continuous positive airway pressure (CPAP) adherence and response to CPAP problems in male patients with obstructive sleep apnea (OSA).
Wives' involvement (pressure, support, and collaboration), CPAP adherence and CPAP problems (e.g., mask leaks) were assessed for 10 days in 31 male OSA patients. Disease severity and pre-treatment ratings of relationship quality were tested as moderators of daily associations in multilevel models. Effects of wives' involvement were tested as predictors of day-to-day adherence and average nightly adherence at 3 months.
Perception of wives' support predicted increased adherence only in patients with high disease severity. Collaboration increased following nights with lower adherence and greater CPAP problems. Patients with lower conflict in the relationship reported a greater increase in collaboration associated with CPAP problems. Patients with lower support in the relationship reported increased next-day support following nights with CPAP problems. Perceived pressure from the wife was not associated with increased adherence in day-to-day analyses and associated with poorer adherence at 3 months.
The relationship between wives' involvement and adherence was bidirectional and influenced by disease and relationship context. The majority of findings demonstrated increased positive wife involvement as a reaction to adherence and problems with CPAP. Supportive and collaborative interventions have the potential to improve CPAP adherence and response to CPAP-related problems, particularly in patients with high disease severity. Pressure to use CPAP from the wife was not beneficial for adherence that day and predicted poorer adherence at 3 months. Further research is needed to test supportive spousal involvement as an adherence intervention.
确定配偶参与对男性阻塞性睡眠呼吸暂停（OSA）患者持续气道正压通气（CPAP）依从性和 CPAP 问题反应的影响。
在 31 名男性 OSA 患者中，评估了妻子的参与（压力、支持和合作）、CPAP 依从性和 CPAP 问题（例如面罩泄漏），为期 10 天。在多层次模型中，以疾病严重程度和治疗前关系质量评分作为每日关联的调节因素进行了测试。以妻子的参与程度作为预测因素，测试了其对每日依从性和 3 个月时平均夜间依从性的影响。
仅在疾病严重程度高的患者中，妻子支持的感知预测了更高的依从性。合作在夜间依从性降低和 CPAP 问题增加时增加。在关系中冲突较少的患者报告，与 CPAP 问题相关的合作增加幅度更大。在关系中支持较少的患者报告，在 CPAP 问题夜间之后，第二天的支持增加。妻子的压力感知与日间分析中的依从性增加无关，与 3 个月时的依从性较差相关。
妻子参与和依从性之间的关系是双向的，受到疾病和关系背景的影响。大多数研究结果表明，妻子的参与增加，是对依从性和 CPAP 相关问题的积极反应。支持性和协作性干预措施有可能提高 CPAP 依从性和对 CPAP 相关问题的反应，特别是在疾病严重程度较高的患者中。来自妻子的使用 CPAP 的压力对当天的依从性没有益处，并预测了 3 个月时的依从性较差。需要进一步研究以测试支持性的配偶参与作为一种依从性干预措施。
