title: Validation of the CPAP Habit Index-5: A Tool to Understand Adherence to CPAP Treatment in Patients with Obstructive Sleep Apnea.
abstract: Long-term adherence to continuous positive airway pressure (CPAP) is low among patients with obstructive sleep apnea (OSA). The potential role of "habit" in sustaining adherence to CPAP use has not been studied. This study aimed to establish the relevance of habit to CPAP adherence, via validation of an adaptation of the Self-Report Habit Index (the CPAP Habit Index-5; CHI-5). Analyses focused on the homogeneity, reliability, and factor structure of the CHI-5 and, in line with theoretical predictions, its utility as a predictor of long-term CPAP adherence in middle-aged patients with OSA. A prospective longitudinal design was used. 117 patients with objectively verified OSA intended for CPAP treatment were recruited. Data was collected via clinical examinations, respiratory recordings, questionnaires, and CPAP devices at baseline, 2 weeks, 6 months, and 12 months. The CHI-5 showed satisfactory homogeneity interitem correlations (0.42-0.93), item-total correlations (0.58-0.91), and reliability ( α = 0.92). CHI-5 data at 6 months showed a one-factor solution and predicted 63% of variance in total CPAP use hours after 12 months. Based on the satisfactory measurement properties and the high amount of CPAP use variance it explained, the CHI-5 can be seen as a useful tool in clinical practice.
authors.affiliation: Department of Nursing Science, School of Health Sciences, Jönköping University, 551 11 Jönköping, Sweden ; Department of Clinical Neurophysiology, Linköping University Hospital, 581 85 Linköping, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Broström
authors.affiliation: Division of Health Care Analysis, Faculty of Health Sciences, Department of Health and Society, Linköping University, 581 83 Linköping, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Nilsen
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK.
authors.forename: Benjamin
authors.identifier: 0000-0003-1223-5934
authors.initials: B
authors.lastname: Gardner
authors.affiliation: Department of Cardiology, Linköping University Hospital, 581 85 Linköping, Sweden.
authors.forename: Peter
authors.identifier: 0000-0001-7431-2873
authors.initials: P
authors.lastname: Johansson
authors.affiliation: Department of Clinical Neurophysiology, Linköping University Hospital, 581 85 Linköping, Sweden ; Departement of Clinical and Experimental Medicine, Division of Clinical Neurophysiology, Faculty of Health Sciences, Linköping University, 581 83 Linköping, Sweden.
authors.forename: Martin
authors.identifier: 0000-0002-3810-0432
authors.initials: M
authors.lastname: Ulander
authors.affiliation: School of Health Sciences, Jönköping University, 551 11 Jönköping, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Fridlund
authors.affiliation: Faculty of Health and Life Sciences, Linnaeus University, 391 82 Kalmar, Sweden ; Department of Medicine and Health Sciences, Linköping University, 581 83 Linköping, Sweden ; Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, 100 61 Stockholm, Sweden.
authors.forename: Kristofer
authors.initials: K
authors.lastname: Arestedt