Do Cognitive Perceptions Influence CPAP Use?

Objective: Nonadherence to CPAP increases health and functional risks of obstructive sleep apnea. The study purpose was to examine if disease and treatment cognitive perceptions influence short-term CPAP use. Methods: A prospective longitudinal study included 66, middle-aged (56.7 yr ± 10.7) subjects (34 [51.5%] Caucasians; 30 [45.4%] African Americans) with severe OSA (AHI 43.5 events/hr ±24.6). Following full-night diagnostic/CPAP polysomnograms, home CPAP use was objectively measured at 1 week and 1 month. The Self Efficacy Measure for Sleep Apnea questionnaire (SEMSA), measuring risk perception, outcome expectancies, and self-efficacy, was collected at baseline, post-CPAP education, and after 1 week CPAP treatment. Regression models were used. Results: CPAP use at one week was 3.99 hr/night ± 2.43 and 3.06 hr/night ± 4.50 at one month. No baseline SEMSA domains influenced CPAP use. Post-education self-efficacy influenced one week CPAP use (1.52±0.53, p=0.007). Self-efficacy measured post-education and after one week CPAP use also influenced one month CPAP (1.40±0.52, p=0.009; 1.20±0.50, p=0.02, respectively). Conclusion: Cognitive perceptions influence CPAP use, but only within the context of knowledge of CPAP treatment and treatment use. Practice Implications: Patient education is important to OSA patients’ formulation of accurate and realistic disease and treatment perceptions which influence CPAP adherence.