Multidimensional Evaluation of Continuous Positive Airway Pressure (CPAP) Treatment for Sleep Apnea in Different Clusters of Couples

J Clin Med. 2020 Jun 1;9(6):1658. doi: 10.3390/jcm9061658.


Continuous positive airway pressure (CPAP) is the most efficient treatment of obstructive sleep apnea (OSA). Little is known about the impact of spousal relationship profiles on CPAP adherence. We aimed to identify clusters of couples of OSA patients, and their association with CPAP adherence 120 days after CPAP initiation. In a multicenter prospective study, OSA patients recently prescribed CPAP were enrolled with their spouses. Data about spousal relationships were collected at inclusion and at day 120. Latent class analysis was performed to determine homogeneous groups of spousal relationships. The 290 participants were predominantly males (77%), median age was 53 years and interquartile range (IQR) 46-62, median body mass index (BMI) was 32 kg/m² (IQR: 28.6-35.9) and median apnea-hypopnea index: 43 events per hour (IQR: 33-58). Three couple clusters were identified: 1) older retired couples, 2) young working couples, and 3) mature active couples. Patients in the older retired couples cluster presented the highest CPAP adherence (p < 0.01) independently of initial complaints, OSA severity, and degree of improvement under CPAP. In a large cohort of OSA patients in whom clusters of couples were determined, there was a significant difference in CPAP adherence at day-120 after CPAP initiation.

Keywords: adherence; continuous positive airway pressure; latent class analysis; marital quality; obstructive sleep apnea.