title: Predicting uptake of continuous positive airway pressure (CPAP) therapy in obstructive sleep apnoea (OSA): a belief-based theoretical approach.
abstract: OBJECTIVE
  Obstructive sleep apnoea (OSA) is a common disorder, for which continuous positive airway pressure (CPAP) therapy is a standard treatment. Despite its well-established efficacy, many patients choose not to initiate CPAP treatment. The present study investigated the degree to which biological measures (e.g. Apnoea-Hypopnoea Index [AHI]), symptom experiences (e.g. fatigue) and illness representations (e.g. perceived consequences) predict the decision of individuals newly diagnosed with OSA to undergo a trial of CPAP therapy.
  
  
  METHODS
  Four hundred forty-nine individuals (316 males) newly diagnosed with OSA. Epworth sleepiness scale (ESS), Fatigue Severity Scale, Depression Anxiety Stress Scale and Illness Perception Questionnaire-Revised (IPQ-R) were administered at time of sleep study. These, patient demographics and sleep study variables were used to determine factors predicting patient decision to proceed with a trial of CPAP.
  
  
  RESULTS
  The participants were most likely to attribute their OSA to unchangeable and psychological factors. For those with moderate OSA (AHI, 15 to 30) IPQ-R illness consequence was predictive of decision to initiate CPAP (p = 0.002). For severe OSA (AHI >30) age, ESS and IPQ illness causal beliefs were predictive of decision to initiate CPAP (p < 0.001).
  
  
  CONCLUSIONS
  Illness beliefs are important determinants of the choice of recently diagnosed OSA patients whether or not to undertake a trial of CPAP therapy. Concerns about illness consequences were important in those with moderate OSA. In severe OSA, sleepiness symptoms are more prominent and a more significant determinant of CPAP uptake along with age and causal beliefs.
authors.affiliation: Psychological and Clinical Sciences, Charles Darwin University, Darwin, Northern Territory, 0909, Australia, timothy.skinner@cdu.edu.au.
authors.forename: Timothy
authors.initials: T
authors.lastname: Skinner
authors.forename: Lindsay
authors.initials: L
authors.lastname: McNeil
authors.forename: Michelle
authors.initials: M
authors.lastname: Olaithe
authors.forename: Peter
authors.initials: P
authors.lastname: Eastwood
authors.forename: David
authors.initials: D
authors.lastname: Hillman
authors.forename: Janet
authors.initials: J
authors.lastname: Phang
authors.forename: Tamara
authors.initials: T
authors.lastname: de Regt
authors.forename: Romola S
authors.initials: RS
authors.lastname: Bucks
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D045422:Continuous Positive Airway Pressure / Q000523:psychology*; D003469:Culture; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D017286:Polysomnography / Q000523:psychology; D011582:Psychological Theory; D012648:Self Care / Q000523:psychology; D020181:Sleep Apnea, Obstructive / Q000523:psychology* / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult