title: What is known about the experiences of using CPAP for OSA from the users' perspective? A systematic integrative literature review.
abstract: Economic, social and personal costs of untreated obstructive sleep apnoea (OSA) are high. Continuous positive airway pressure (CPAP) is recommended and cost effective. Increasing OSA prevalence may accompany predicted globally increasing obesity.
  
  
  OBJECTIVE
  To synthesise international evidence regarding personal experiences using CPAP for OSA.
  
  
  METHODS
  A systematic integrative literature review was conducted and quality assessment criteria applied.
  
  
  RESULTS
  22, of 538, identified papers met inclusion criteria. Thematic analysis identified three themes: 1) users' beliefs about CPAP influence users' experiences of CPAP; 2) CPAP users are primed to reflect negatively on experiences of CPAP; and 3) spouse and family influence users' experiences of CPAP. Personality and attitude impact expectations about CPAP prior to use, whilst engagement of spouse and family also influence experiences. Analysis highlighted that users' reporting of CPAP experiences is constrained by investigator defined assessment methods. Overall, research relating to experiences using CPAP is limited.
  
  
  CONCLUSIONS
  Users' perspectives of CPAP are constrained by researchers' concern with non-compliance. Typically experiences are not defined by the user, but from an 'expert' healthcare perspective, using words which frame CPAP as problematic. Family and social support is a significant, but neglected area of experiencing CPAP warranting further investigation. More information from users is required to determine how CPAP can be managed successfully.
authors.affiliation: The University of Auckland, New Zealand. Electronic address: k.ward@auckland.ac.nz.
authors.forename: Kim
authors.initials: K
authors.lastname: Ward
authors.affiliation: The University of Auckland, New Zealand.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Hoare
authors.affiliation: The University of Auckland, New Zealand.
authors.forename: Merryn
authors.initials: M
authors.lastname: Gott
mesh_terms: D001294:Attitude to Health; D045422:Continuous Positive Airway Pressure / Q000523:psychology; D006801:Humans; D010349:Patient Compliance / Q000523:psychology; D017060:Patient Satisfaction; D020181:Sleep Apnea, Obstructive / Q000628:therapy*
keywords: Continuous positive airway pressure; Hypopnoea; Integrative review; Nasal CPAP; Obstructive sleep apnoea; Patient experiences