title: Investigating reasons for CPAP adherence in adolescents: a qualitative approach.
abstract: OBJECTIVE
  Adolescents with obstructive sleep apnea syndrome (OSAS) represent an important but understudied subgroup of long-term continuous positive airway pressure (CPAP) users. The purpose of this qualitative study was to identify factors related to adherence from the perspective of adolescents and their caregivers.
  
  
  METHODS
  Individual open-ended, semi-structured interviews were conducted with adolescents (n = 21) and caregivers (n = 20). Objective adherence data from the adolescents' CPAP machines during the previous month was obtained. Adolescents with different adherence levels and their caregivers were asked their views on CPAP. Using a modified grounded theory approach, we identified themes and developed theories that explained the adolescents' adherence patterns.
  
  
  RESULTS
  Adolescent participants (n = 21) were aged 12-18 years, predominantly male (n = 15), African American (n = 16), users of CPAP for at least one month. Caregivers were mainly mothers (n = 17). Seven adolescents had high use (mean use 381 ± 80 min per night), 7 had low use (mean use 30 ± 24 min per night), and 7 had no use during the month prior to being interviewed. Degree of structure in the home, social reactions, mode of communication among family members, and perception of benefits were issues that played a role in CPAP adherence.
  
  
  CONCLUSIONS
  Understanding the adolescent and family experience of using CPAP may be key to increasing adolescent CPAP adherence. As a result of our findings, we speculate that health education, peer support groups, and developmentally appropriate individualized support strategies may be important in promoting adherence. Future studies should examine these theories of CPAP adherence.
authors: Sleep Center, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors: Priya S
authors: PS
authors: Prashad
authors: Carole L
authors: CL
authors: Marcus
authors: Jill
authors: J
authors: Maggs
authors: Nicolas
authors: N
authors: Stettler
authors: Mary A
authors: MA
authors: Cornaglia
authors: Priscilla
authors: P
authors: Costa
authors: Kristina
authors: K
authors: Puzino
authors: Melissa
authors: M
authors: Xanthopoulos
authors: Ruth
authors: R
authors: Bradford
authors: Frances K
authors: FK
authors: Barg
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology / Q000523:psychology*; D002648:Child; D045422:Continuous Positive Airway Pressure / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data*; D005190:Family / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data*; D020181:Sleep Apnea, Obstructive / Q000523:psychology / Q000628:therapy*
keywords: CPAP adherence; Qualitative; adolescent; interviews