Sleep disruption caused by obstructive sleep apnea (OSA) affects nearly 5% of people throughout the world and upwards of 15% of Americans. OSA is characterized by respiratory interruptions that cause a person to wake from sleep in order to begin breathing again. Medically, these conditions are referred to as hypoxia and sleep fragmentation. “Daytime sleepiness and hypoxia of the brain are associated with cognitive deficits, such as impaired working memory, attention, and psychomotor problems,” said Sara Olsen of the Psychology Department at Royal Brisbane and Women’s Hospital in Australia. “Hypoxia of the heart increases the risk of heart-related diseases, such as hypertension.” Overall, lack of sleep and impaired cognition can lead to decreased physical health and increased risk for injury, such as car accidents.

The most common treatment for OSA is continuous positive airway pressure (CPAP) therapy. However, close to one third of all people with OSA refuse to use a CPAP when prescribed one, and of those who begin treatment, only half adhere to it. “There is now strong evidence that individual psychological factors, over and above biomedical factors associated with the treatment, explain a significant degree of the variance in CPAP acceptance and adherence,” said Olsen. Together with her colleagues, Olsen developed a motivational interview nurse therapy (MINT) intervention to improve adherence. “Such interventions have been shown to improve patient adherence to prescription drug regimens and diet and exercise programs and to improve attendance at outpatient treatment clinics.” Olsen added, “Furthermore, it can be effective over just a few sessions, particularly when delivered according to a manualized protocol.”

Olsen enrolled 106 newly diagnosed OSA clients in three sessions of MINT and compared them to a control group. “As expected, CPAP acceptance and adherence was higher in participants randomly allocated to MINT compared to the participants who were allocated to control,” said Olsen. “Specifically, the participants in MINT were six times more likely to commence on CPAP (accept treatment) and used CPAP for nearly 50% more hours per night than participants in the control group.” She added, “This study demonstrated that intervening very early in the treatment process, beginning before CPAP titration, can promote CPAP acceptance and subsequent acceptance.”

Reference:
Olsen, S., Smith, S. S., Oei, T. P. S., & Douglas, J. (2011, November 21). Motivational Interviewing (MINT) Improves Continuous Positive Airway Pressure (CPAP) Acceptance and Adherence: A Randomized Controlled Trial. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0026302

© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

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