Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia; Institute for Breathing and Sleep, Heidelberg, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Australia.
Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, Australia.
Sleep Med. 2023 Sep;109:202-210. doi: 10.1016/j.sleep.2023.06.024. Epub 2023 Jul 3.
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).
81 participants (mean age 52.1 ± 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.
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.
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.
评估量身定制的干预方案在提高阻塞性睡眠呼吸暂停（OSA）患者持续气道正压通气（CPAP）使用和自我效能方面的效果。
81 名（平均年龄 52.1±11.6 岁；女性 35 名）OSA 患者被随机分配到多维干预组（PSY CPAP，n=38）或常规治疗组（TAU CPAP，n=43）。干预措施包括 CPAP 开始前的一次心理教育课程、CPAP 开始后最初几周的一次强化心理教育课程、开始后第 1 天和第 7 天的随访电话，以及第 14 天的复查预约。在第 1 周、第 1 个月和第 4 个月比较 PSY CPAP 和 TAU CPAP 组的 CPAP 使用情况。在初始心理教育课程后以及第 1 个月和第 4 个月比较两组的自我效能评分（风险感知、结果预期和 CPAP 自我效能）。
在所有时间点，PSY CPAP 组的 CPAP 使用量均高于 TAU CPAP 组（p=0.02）。PSY CPAP 参与者的结果预期随时间显著改善（p=0.007）。PSY CPAP 参与者的风险感知在第 1 周与 CPAP 使用相关（p=0.02）。然而，风险感知并没有介导第 1 周时组间 CPAP 使用的差异。
旨在提高自我效能的干预措施，在 CPAP 开始前实施，在 CPAP 治疗早期重复实施，并结合全面的随访方案，可能会提高 CPAP 的使用。持续改善 CPAP 的使用是最终目标，但仍需进一步研究。
