Putative facilitators and barriers for adherence to CPAP treatment in patients with obstructive sleep apnea syndrome: a qualitative content analysis

Sleep Med. 2010 Feb;11(2):126-30. doi: 10.1016/j.sleep.2009.04.010. Epub 2009 Dec 9.


Introduction: Effective treatment of obstructive sleep apnea syndrome (OSAS) with continuous positive airway pressure (CPAP) can reduce morbidity and mortality, but adherence rates are low without a clear consensus of causes.

Objective: To explore the experiences of adherence to CPAP treatment in patients with OSAS.

Methods: A qualitative content analysis was employed. Data were collected by in-depth interviews with 23 purposively selected patients.

Results: Adherence to CPAP treatment was summarized according to "facilitators" and "barriers" to CPAP treatment. Facilitators for adherence, as described by the patients were a desire to avoid symptoms, knowledge about the risk for medical consequences, fear of negative social consequences and disturbing the sleep of significant others. Other facilitators were a positive attitude to CPAP treatment, trust in healthcare personnel, a sense of engagement from the spouse and a feeling of physical improvement. Barriers included experiencing practical problems, negative psychological effects of the equipment, and negative attitudes to the treatment. Other barriers were side-effects as well as insufficient support from healthcare personnel and the spouse.

Conclusion: Adherence to CPAP treatment is a multifaceted problem including patient, treatment, condition, social and healthcare related factors. Knowledge about facilitators and barriers for adherence to CPAP treatment can be used in interventional strategies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Attitude to Health
  • Continuous Positive Airway Pressure* / psychology
  • Family / psychology
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Patient Compliance* / psychology
  • Sleep Apnea, Obstructive / psychology
  • Sleep Apnea, Obstructive / therapy*