Sleep Apnea and Behavioural Techniques

If you have been prescribed to positive airway pressure (PAP) treatment, you know that there are certain difficulties associated with using these devices. It is strange to sleep with something attached to you, especially when it’s attached to your face. For many, the struggles of using the machine are too much, and they simply can’t stand it. But what if there were certain strategies that could be used to improve comfort – mental and physical – associated with machine use. Recently, a technique for increasing comfort was tested on PAP devices to see whether it could be effective for increasing use.

This type of supportive therapy, called MINT (motivational interviewing) is aimed at raising patient awareness of the dangers of untreated sleep apnea, awareness about how side-effects are a small price to pay when weighing benefits and burdens, and awareness of how effective PAP treatment actually is. In this study, 100 subjects with newly diagnosed sleep apnea were used, half of which were assigned to MINT and half of which were not. The MINT session consisted of a 45-minute educational session regarding the previously mentioned issues. About two weeks later, another short educational session was given. After one month, those in the MINT condition were brought back to the lab for another similar educational session. Those in the non-MINT condition received standard care that is typically provided to those recently prescribed to CPAP. Subject machine use was tracked through the electronic chip located within the PAP machine.

When comparing the MINT group to the standard treatment group, results showed the MINT group had a 6% rejection rate of their treatment and the non-MINT group had a 28% rejection rate at 3-month follow-up. Also, those in the MINT condition used their PAP device for about 4.6 hours per night, whereas the non-MINT group only used their machine for 3.2 hours per night. These differences remained throughout follow-ups until the 12-month mark1.

This study suggests that a small intervention at the beginning of the treatment period does indeed encourage PAP device users to use their treatment more often and more effectively. Perhaps it was the educational advice that they received, or perhaps it was just the feeling of support that helped them make the decision to use their machine. Regardless, it should be stated that mentally increasing comfort with this device helped users cope with the physical issues associated with the machine. This should give hope to those who are uncomfortable using their machine at night. A complementary behavioral relaxation technique may just be the key to lead you to PAP use, leading to a healthier and happier life.

 

References: 

 

Olsen, Sara L., Smith, Simon S., Oei, Tian, & Douglas, James (2011) Motivational Interviewing (MINT) improves Continuous Positive Airway Pressure (CPAP) acceptance and adherence : a randomised controlled trial. Journal of Consulting and Clinical Psychology.


Janna Mantua

Author

Janna is a PhD Student / Graduate Research Assistant at University of Massachusetts Amherst with a background in clinical sleep research and psychology. Janna Mantua is a PhD student in the Behavioral Neuroscience department at the University of Massachusetts. Her research focuses on sleep and aging, with specific projects on cognitive health, inflammation, memory formation, and neuroimaging. Prior to her PhD work, Janna was involved in research on sleep apnea and cognitive decline at the NYU Sleep Disorders Center.



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