Bouvé College of Health Sciences School of Nursing, Northeastern University, Boston, MA, USA.
William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, USA.
Sleep Health. 2017 Oct;3(5):362-367. doi: 10.1016/j.sleh.2017.07.003. Epub 2017 Jul 25.
The majority of adults sleep with a partner, making sleep a dyadic experience. However, interventions to improve sleep have primarily focused on individuals. This qualitative analysis used a dyadic approach to identify facilitators and barriers to successful treatment of one of the most common sleep disorders, obstructive sleep apnea, with continuous positive airway pressure (CPAP).
Twenty joint qualitative interviews were conducted with couples, one couple at a time, with a sample of 20 patients with obstructive sleep apnea and their partners to develop an understanding of couples' experiences with CPAP use. Interviews were audio recorded and transcribed. Conventional qualitative content analysis was used to analyze the interview data.
Facilitators of CPAP use were the following: the partner aiding diagnosis and treatment, couples working together using CPAP, the perceived benefits of CPAP for both partners, the patient being motivated to use CPAP for the benefit of the partner, and various types of support provided by the partner to encourage CPAP use. Major barriers to CPAP use were the following: anxiety related to CPAP use particularly in the beginning of therapy, bothersome equipment causing disruptions in sleep and bedtime routine, interruptions to intimacy, and concern about image change while wearing CPAP.
Findings from this study suggest that couple-directed interventions that advocate for a mutually engaging perspective and promote supportive relationships and positive dyadic coping may be targets for improving CPAP adherence. Further research evaluating the potential of couple-focused interventions to improve sleep health is warranted.
大多数成年人都是与伴侣同床共枕,使睡眠成为一种双重体验。然而,改善睡眠的干预措施主要集中在个人身上。本定性分析采用对偶方法,旨在确定使用持续气道正压通气(CPAP)成功治疗最常见的睡眠障碍之一阻塞性睡眠呼吸暂停的促进因素和障碍因素。
每次一对夫妇,共对 20 对夫妇进行了 20 次联合定性访谈,研究对象为 20 名阻塞性睡眠呼吸暂停患者及其伴侣,以了解夫妇使用 CPAP 的体验。访谈进行了录音和转录。采用常规定性内容分析法对访谈数据进行分析。
CPAP 使用的促进因素如下:伴侣协助诊断和治疗、夫妻共同使用 CPAP、双方都认为 CPAP 有好处、患者为了伴侣的利益而有动力使用 CPAP、伴侣提供各种形式的支持以鼓励使用 CPAP。CPAP 使用的主要障碍如下:对 CPAP 使用的焦虑,尤其是在治疗初期、设备令人不适,会干扰睡眠和睡前常规、性生活中断、以及担心佩戴 CPAP 时形象改变。
这项研究的结果表明,以相互参与的视角为重点的夫妻干预措施,并促进支持性的关系和积极的对偶应对,可能是提高 CPAP 依从性的目标。进一步研究评估以夫妻为中心的干预措施改善睡眠健康的潜力是有必要的。