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 ± 10.7. yr) 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 (SEMSA) questionnaire, 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 ± 2.48. h/night and 3.06 ± 2.43. h/night 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.