Putative facilitators and barriers for adherence to CPAP treatment in patients with obstructive sleep apnea syndrome: a qualitative content analysis.
BACKGROUND
Effective treatment of obstructive sleep apnea syndrome (OSAS) with continuous positive airway pressure (CPAP) can reduce morbidity and mortality, but adherence rates are low without a clear consensus of causes.


OBJECTIVE
To explore the experiences of adherence to CPAP treatment in patients with OSAS.


METHODS
A qualitative content analysis was employed. Data were collected by in-depth interviews with 23 purposively selected patients.


RESULTS
Adherence to CPAP treatment was summarized according to "facilitators" and "barriers" to CPAP treatment. Facilitators for adherence, as described by the patients were a desire to avoid symptoms, knowledge about the risk for medical consequences, fear of negative social consequences and disturbing the sleep of significant others. Other facilitators were a positive attitude to CPAP treatment, trust in healthcare personnel, a sense of engagement from the spouse and a feeling of physical improvement. Barriers included experiencing practical problems, negative psychological effects of the equipment, and negative attitudes to the treatment. Other barriers were side-effects as well as insufficient support from healthcare personnel and the spouse.


CONCLUSIONS
Adherence to CPAP treatment is a multifaceted problem including patient, treatment, condition, social and healthcare related factors. Knowledge about facilitators and barriers for adherence to CPAP treatment can be used in interventional strategies.
Broström
Anders
A
Department of Clinical Neurophysiology, University Hospital, Linköping, Sweden. andbr@imv.liu.se
Nilsen
Per
P
Johansson
Peter
P
Ulander
Martin
M
Strömberg
Anna
A
Svanborg
Eva
E
Fridlund
Bengt
B
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D045422:Continuous Positive Airway Pressure / Q000523:psychology; D005190:Family / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D020181:Sleep Apnea, Obstructive / Q000523:psychology / Q000628:therapy*