An update on behavioural interventions for improving adherence with continuous positive airway pressure in adults

Obstructive sleep apnoea (OSA) is a common sleep disorder which if left untreated results in considerable physical and psychological co-morbidity and mortality. With the development of continuous positive airway pressure (CPAP), an effective treatment was available to counteract the partial and complete airway closures, hypoxia and sleep fragmentation. Technological advances in CPAP devices improved the interface between machine and man, reduced noise levels and improved many aspects of the treatment process. Yet, with all these advancements over the last 35 years, adherence to CPAP remains low. There are a number of underlying factors in the poor uptake and discontinuation of treatment. Previous CPAP adherence interventions are discussed along with behavioural programmes which have emerged in the last 3 years. Of importance are the insights gained from emerging qualitative research in this area to enable a better understanding of patient perceptions and how these continue to impact on adherence rates.