title: Effects of patient education and progressive muscle relaxation alone or combined on adherence to continuous positive airway pressure treatment in obstructive sleep apnea patients.
abstract: OBJECTIVE
  The purpose of this study is to explore the effects of patient education and progressive muscle relaxation (PMR) alone or combined on adherence to continuous positive airway pressure (CPAP) treatment in obstructive sleep apnea (OSA) patients.
  
  
  METHODS
  One hundred and fifty-two Han Chinese OSA patients were randomly assigned to a control group (C), an education group (E), a PMR group (P), and an education + PMR group (E + P), with 38 patients each group. The adherence to CPAP was defined as 4 or more hours of CPAP usage per night and at least 9 of each 14 nights of ventilator use. The CPAP adherence rates, cumulative patient dropout rates, CPAP usage, and scores of daytime sleepiness, sleep quality, anxiety, and depression were compared among the groups at 4, 8, and 12 weeks of intervention.
  
  
  RESULTS
  All study groups were comparable in baseline characteristics. Group E + P showed significant improvement in CPAP adherence, daytime sleepiness, and sleep quality compared with group C at 4, 8, and 12 weeks of intervention. Compared with group C, group E only showed significant improvement in CPAP adherence, daytime sleepiness, and sleep quality at 4 weeks of intervention, while group P showed no significant improvement over time. Scores of anxiety and depression were significantly improved in group E + P compared with group C at 12 weeks of intervention.
  
  
  CONCLUSIONS
  Combined intervention with patient education and PMR can significantly improve CPAP adherence in OSA patients for at least 12 weeks. The intervention paradigm may serve as an important reference for future studies on CPAP adherence.
authors.affiliation: School of Nursing, Central South University, No. 172 Tongzipo Road, Changsha, Hunan, 410013, People's Republic of China.
authors.forename: Weihong
authors.initials: W
authors.lastname: Wang
authors.forename: Guoping
authors.initials: G
authors.lastname: He
authors.forename: Meirong
authors.initials: M
authors.lastname: Wang
authors.forename: Lihua
authors.initials: L
authors.lastname: Liu
authors.forename: Huaqing
authors.initials: H
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D002681:China; D003131:Combined Modality Therapy; D045422:Continuous Positive Airway Pressure; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D017286:Polysomnography; D012064:Relaxation Therapy; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D011795:Surveys and Questionnaires