title: Social-cognitive correlates of CPAP adherence in experienced users.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) is a condition with serious medical and psychosocial consequences. However, poor adherence with nasal continuous positive airway pressure (CPAP) treatment limits the effectiveness of treatment. Behavior change factors offer one avenue of research to better understand the correlates of CPAP adherence.
  
  
  METHODS
  Fifty-eight participants who had been diagnosed with OSA and prescribed CPAP treatment agreed to complete questionnaires that assessed sleep apnea symptoms, behavior change factors, and CPAP side effects, and to have their CPAP data downloaded. Behavior change factors from both social cognitive theory (SCT) and the transtheoretical model (TM) were assessed. The primary aim of the study was to examine the relationship between these social-cognitive factors and objectively measured CPAP adherence.
  
  
  RESULTS
  Participants had been using CPAP for a mean of 2.1 years. SCT variables (adjusted R(2)=0.115, P=.008) and TM variables (adjusted R(2)=0.157, P<.0001) each accounted for a statistically significant amount of variance in CPAP adherence.
  
  
  CONCLUSIONS
  The results suggest that social-cognitive factors may be associated with CPAP adherence in experienced CPAP users. The principal advantage to these theory-driven and empirically validated factors is that they are modifiable and can provide the basis for effective interventions to increase CPAP adherence.
authors.affiliation: Health Services Research and Development Unit (111N-1), Veteran Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA. carl.stepnowsky@med.va.gov
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Stepnowsky
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Marler
authors.forename: Joe
authors.initials: J
authors.lastname: Palau
authors.forename: J
authors.initials: J
authors.lastname: Annette Brooks
mesh_terms: D015992:Body Mass Index; D003071:Cognition; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012919:Social Behavior; D011795:Surveys and Questionnaires