Coping Processes, Self-Efficacy, and CPAP Use in Adults With Obstructive Sleep Apnea

Abstract

<i>Background</i>: Coping strategies are predictive of 1 week CPAP use. Coping strategies may predict longer-term CPAP use among adults with obstructive sleep apnea (OSA). <i>Objectives</i>: To investigate the influence of two coping styles (active and passive) and individual coping processes on CPAP use at 1 week and 1 month; and explore the association between self-efficacy and coping on CPAP use. <i>Participants</i>: CPAP-naïve adults (52.3% male, 90.9% White) newly diagnosed with OSA (AHI ≥ 5 events/hr) from two U.S. clinical sleep centers (<i>n</i> = 66). <i>Methods</i>: A post-hoc analysis from a prospective, longitudinal study that examined influential factors on CPAP use among CPAP-naïve patients with newly diagnosed OSA. The Ways of Coping Questionnaire and the Self-Efficacy Measure for Sleep Apnea were completed immediately after CPAP titration polysomnography. Objective 1 week and 1 month CPAP use (mean hr/night) were the primary outcomes. Descriptive analyses and stepwise multiple linear regression analyses modeling for CPAP use (mean hr/night). <i>Results</i>: Active coping was significantly associated with greater CPAP use (mean hr/night) at 1 week, but not at 1 month (<i>p</i> = 0.0397; <i>p</i> = 0.0556, respectively). Higher Planful Problem Solving was significantly associated with greater average CPAP use at 1 week and 1 month (<i>p</i> = 0.0117, <i>p</i> = 0.0378, respectively). Self-efficacy was significantly associated with greater average CPAP use at 1 week (<i>p</i> = 0.0056) and 1 month (<i>p</i> = 0.0056). <i>Conclusions</i>: Self-efficacy and Planful Problem Solving coping are promising behavioral intervention targets to promote CPAP use in newly diagnosed OSA.