An Adaptive Treatment to Improve Positive Airway Pressure (PAP) Adherence in Patients With Obstructive Sleep Apnea: A Proof of Concept Trial

Behav Sleep Med. 2017 Sep-Oct;15(5):345-360. doi: 10.1080/15402002.2015.1135292. Epub 2016 Apr 20.


Despite the benefits of positive airway pressure (PAP) treatment, rates of adherence to treatment are suboptimal. This proof-of-concept study assessed the feasibility, acceptability, and clinical significance of an adaptive treatment strategy to improve adherence to PAP. All participants first completed a brief educational intervention. Those who did not show at least a 25% increase in PAP use were randomized to receive a second, more intensive intervention, either motivational enhancement treatment or self-management treatment. Results suggested adequate feasibility and acceptability. In addition, participants demonstrated significant increases in objective PAP use, improvements in sleep quality, and decreases in daytime sleepiness. This study represents a first step in the development and validation of an adaptive treatment strategy to improve PAP adherence.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Behavior Therapy*
  • Continuous Positive Airway Pressure / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motivation*
  • Patient Compliance*
  • Sleep Apnea, Obstructive / psychology*
  • Sleep Apnea, Obstructive / therapy*
  • Sleep Stages / physiology