Challenges and motivating factors related to positive airway pressure therapy for post-TIA and stroke patients.

Abstract

Challenges adapting to continuous positive airway pressure (CPAP) therapy are largely unexplored in patients with stroke or transient ischemic attack. This study, nested within a randomized controlled trial of CPAP use, employed qualitative methods to explore challenges and motivators related to CPAP at two time points: prior to initiating therapy and at a 1-month follow up. Emergent thematic analysis, an inductive, qualitative approach, revealed variations in how patients experienced and adapted to CPAP across five phases: (a) interpreting the sleep apnea diagnosis, (b) contemplating CPAP therapy, (c) trying CPAP therapy, (d) making mid-course adjustments, and (e) experiencing benefits from CPAP therapy. Patients all had mild to moderate sleep apnea, and frequently did not experience sleep apnea symptoms. A salient motivator for adhering to CPAP therapy for these patients was the desire to reduce the risk of subsequent cerebrovascular events. Self-determination theory guided the interpretation of results.

• Authors: Marianne S Matthias, Neale R Chumbler, Dawn M Bravata, H Klar Yaggi, Jared Ferguson, Charles Austin, Vincent McClain, Mary I Dallas, Cody D Couch, Nicholas Burrus, Edward J Miech
• Journal: Behavioral sleep medicine (Behav Sleep Med) Vol. 12 Issue 2 Pg. 143-57 (Mar 04 2014) ISSN: 1540-2010 [Electronic] England
• PMID: 23570672 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, Non-P.H.S.)

Topics

• Aged
• Aged, 80 and over
• Continuous Positive Airway Pressure (psychology)
• Female
• Follow-Up Studies
• Humans
• Ischemic Attack, Transient (complications, psychology, therapy)
• Male
• Middle Aged
• Motivation
• Sleep Apnea Syndromes (complications, diagnosis, therapy)
• Stroke (complications, psychology, therapy)
• Time Factors