COMMunication and Education for the New CPAP Experience

Continuous positive airway pressure (CPAP) therapy is an effective treatment for obstructive
sleep apnea (OSA), but adherence is poor. CPAP adherence interventions to date have been met
with limited success. Intervention strategies would be optimized by added support for
patients and alternative strategies for intervention delivery. Significant others (SO) are
likely to exert positive and negative effects on the patient's adoption and use of positive
airway pressure (PAP) therapy and are frequently described as the greatest source of social
support for patients with chronic illness. Beginning the intervention before PAP initiation
would capitalize on the teachable moment shortly following diagnosis when education and
social support may be most essential. The aims of the research plan are to examine the
effects of a couple-oriented education and support intervention on patient- and
partner-reported outcomes as compared to a patient-oriented education and support
intervention and usual care and to examine the relationship between PAP adherence and
patients' and partners' sleep quality and daytime functioning. Patients in the pilot study
will be randomized to the couple-oriented intervention, patient-oriented intervention, or
standard clinical care group.

Inclusion Criteria:

Patient:

- Age is 21 years of age and older

- Have spouse or partner

- Polysomnographically (PSG) diagnosed OSA (AHI ≥ 5)

- Choice of continuous positive airway pressure (CPAP) as preferred treatment

Partner:

- Age is 18 years of age and older

- Have spouse or partner who has been diagnosed with OSA and has chosen CPAP as
preferred treatment

Exclusion Criteria:

Patient:

- AHI < 5 on the diagnostic PSG

- Have a spouse or partner with OSA diagnosis and on OSA treatment

- Past treatment for OSA

- Diagnosis of a sleep disorder other than OSA that cause arousals from sleep (e.g.,
central sleep apnea, periodic limb movement disorder, insomnia)

- Diagnosis of a serious medical condition (e.g., end stage renal failure, severe
chronic obstructive lung disease, severe asthma)

- History of or current diagnosis of a major psychiatric illness except depression
(e.g., schizophrenia, bipolar disorder) partner:

- Have been diagnosed with OSA and using CPAP