title: Clinical management of poor adherence to CPAP: motivational enhancement.
abstract: Adherence to continuous positive airway pressure (CPAP) in patients with sleep apnea hypopnea syndrome (SAHS) is poor. Previous studies have attempted to identify specific barriers to treatment, but none has identified the sole cause for the problem. We outline a behavioral approach to the problem of CPAP adherence that is based on the theories of the transtheoretical model and social cognitive theory. We used these theories to guide the development of an intervention based on the methods of motivational interviewing. We present our motivational enhancement therapy for CPAP (ME-CPAP) here, with some brief pilot data to show its efficacy. Finally, we outline some strengths and weaknesses of taking a behavior change approach to the problem of poor CPAP adherence.
authors.affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, RI 02906, USA. mark_aloia@brown.edu
authors.forename: Mark S
authors.initials: MS
authors.lastname: Aloia
authors.forename: J Todd
authors.initials: JT
authors.lastname: Arnedt
authors.forename: Raine L
authors.initials: RL
authors.lastname: Riggs
authors.forename: Jacki
authors.initials: J
authors.lastname: Hecht
authors.forename: Belinda
authors.initials: B
authors.lastname: Borrelli
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000379:methods*; D006801:Humans; D009042:Motivation; D012891:Sleep Apnea Syndromes / Q000628:therapy*; D016312:Treatment Refusal