| Autor: |
Khot, Sandeep P., Barnett, Heather M., Davis, Arielle P., Byun, Eeeseung, McCann, Barbara, Bombardier, Charles H., Rappisi, Korren, Longstreth, W.T., Billings, Martha E., Brown, Devin, Garrison, Michelle M. |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Sleep Med |
| Popis: |
OBJECTIVE/BACKGROUND: Continuous positive airway pressure (CPAP) for the treatment of sleep apnea may improve stroke recovery but is limited by poor adherence. We evaluated early predictors of CPAP use and psychosocial, cognitive, and behavioral determinants of CPAP adherence after stroke. PATIENTS/METHODS: In a single-arm study of an intensive CPAP adherence protocol initiated during stroke rehabilitation, qualifying participants underwent motivational interviewing to set goals and address barriers for CPAP adherence, defined as ≥ 4 hours use during ≥ 70% of nights. We compared commonly experienced early CPAP complaints between adherent and non-adherent patients and performed a thematic analysis of motivational interviewing during rehabilitation and of interviews after 3 months for facilitators and barriers to CPAP adherence. RESULTS: Among 52 participants who chose to continue CPAP after rehabilitation discharge, 32 (62%) were adherent over 3-months. Adherent participants reported fewer early CPAP complaints (p=0.003), including claustrophobia (p=0.02), than non-adherent participants. Facilitators of long-term adherence included improved sleep and stroke symptoms, self-efficacy with CPAP, and positive treatment expectations. Modifiable barriers included CPAP skills, discomfort with a new health technology and common CPAP-related complaints, including anxiety. Several patients described less modifiable barriers such as social stressors, sleep disturbance, and lack of home social support. CONCLUSIONS: Adherence programs for CPAP use after stroke should address modifiable barriers, with early desensitization to improve CPAP-related complaints and claustrophobia, and training to address perceived self-efficacy with CPAP. Future studies should explore individual goals and barriers associated with CPAP use among stroke survivors to improve long-term CPAP adherence. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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