title: Spousal involvement in CPAP: does pressure help?
abstract: OBJECTIVE
  Continuous positive airway pressure (CPAP) improves sleep and quality of life for both patients with obstructive sleep apnea (OSA) and their spouses. However, few studies have investigated spousal involvement in treatment adherence. Aims of this observational study were to assess perceptions of spousal involvement and evaluate associations between involvement and adherence.
  
  
  METHODS
  Spousal involvement in CPAP adherence was assessed in 23 married male OSA patients after the first week of treatment. At 3 months, 16 participants completed a second assessment of spousal involvement. Types of involvement assessed included positive (e.g., encouraging), negative (e.g., blaming), collaboration (e.g., working together), and one-sided (e.g., asking). An interpersonal measure of supportive behaviors was also administered at 3 months to evaluate the interpersonal qualities of spousal involvement types. Objective CPAP adherence data were available for 14 participants.
  
  
  RESULTS
  Average frequency of spousal involvement ratings were low for each involvement type and only negative spousal involvement frequency decreased at 3 month follow-up (p = 0.003). Perceptions of collaborative spousal involvement were associated with higher CPAP adherence at 3 months (r = 0.75, p = 0.002). Positive, negative and one-sided involvement were not associated with adherence. Collaborative spousal involvement was associated with moderately warm and controlling interpersonal behaviors (affiliation, r = 0.55, p = 0.03, dominance r = 0.47, p = 0.07).
  
  
  CONCLUSIONS
  Patients reported low frequency but consistent and diverse perceptions of spousal involvement in CPAP over the first 3 months of treatment. Perceptions of collaborative spousal involvement were the only type associated with adherence and represent moderately warm and controlling interpersonal behavior. Interventions to increase spousal collaboration in CPAP may improve adherence.
authors.affiliation: Department of Neurology, Feinberg School of Medicine, Northwestern University, Abbott Hall, Rm 523, 710 N. Lake Shore Dr., Chicago, IL 60611, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Glazer Baron
authors.forename: Heather E
authors.initials: HE
authors.lastname: Gunn
authors.forename: Laura A
authors.initials: LA
authors.lastname: Czajkowski
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Smith
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Jones
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000523:psychology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008393:Marriage / Q000523:psychology; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D020181:Sleep Apnea, Obstructive / Q000523:psychology / Q000628:therapy; D018454:Spouses / Q000523:psychology