Introduction: Untreated obstructive sleep apnea (OSA) leads to negative health outcomes. Yet, compliance rates for continuous positive airway pressure (CPAP), the gold standard of treatment, range from 30-60%. This study examines how motivational interviewing (MI), a goal-oriented form of psychotherapy, increases CPAP adherence. We hypothesize that MI increases CPAP compliance when incorporated into CPAP follow-up care.
Methods: We developed and trained our staff with a novel MI training protocol consisting of MI background readings and videos, CPAP technician shadowing, and MI role-play for certification. For the clinical trial, newly diagnosed OSA patients from Jefferson’s sleep center will be randomized to either an MI or attention control intervention. Both interventions consist of 9 phone calls made over a 3 month period after CPAP initiation. MI calls focus on eliciting internal motivation for change. Attention control calls focus on building rapport. Compliance data will be downloaded from CPAP smartcards.
Results: The MI and attention control groups will be compared with regard to CPAP adherence (number of hours/ night). Demographic variables including age, gender, BMI, and baseline blood pressure will be collected. The comparative analysis (t-test) of compliance rates will also control for baseline variables (multiple regression). Qualitative information regarding patients’ attitudes toward CPAP will be reported descriptively, and potentially used for secondary analyses.
Discussion: If shown to improve compliance, MI could become the standard of care to improve OSA associated negative health outcomes. Our novel protocol makes MI training and administration accessible and inexpensive.
Downing, Grayton; Green, Caitlin; and Cheng, MD, PhD, Cynthia, "Motivational Interviewing for CPAP Adherence" (2020). Phase 1. Paper 78.