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Patient Educ Couns. 2011 Oct;85(1):85-91. doi: 10.1016/j.pec.2010.10.014. Epub 2010 Nov 10.

Do cognitive perceptions influence CPAP use?

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  • 1University of Pennsylvania School of Nursing, Biobehavioral Health Sciences Division and Biobehavioral Research Center, Philadelphia 19104, USA.



Nonadherence to CPAP increases health and functional risks of obstructive sleep apnea. The study purpose was to examine if disease and treatment cognitive perceptions influence short-term CPAP use.


A prospective longitudinal study included 66, middle-aged (56.7 ± 10.7 yr) subjects (34 [51.5%] Caucasians; 30 [45.4%] African Americans) with severe OSA (AHI 43.5 events/hr ± 24.6). Following full-night diagnostic/CPAP polysomnograms, home CPAP use was objectively measured at 1 week and 1 month. The Self Efficacy Measure for Sleep Apnea (SEMSA) questionnaire, measuring risk perception, outcome expectancies, and self-efficacy, was collected at baseline, post-CPAP education, and after 1 week CPAP treatment. Regression models were used.


CPAP use at one week was 3.99 ± 2.48 h/night and 3.06 ± 2.43 h/night at one month. No baseline SEMSA domains influenced CPAP use. Post-education self-efficacy influenced one week CPAP use (1.52 ± 0.53, p=0.007). Self-efficacy measured post-education and after one week CPAP use also influenced one month CPAP (1.40 ± 0.52, p=0.009; 1.20 ± 0.50, p=0.02, respectively).


Cognitive perceptions influence CPAP use, but only within the context of knowledge of CPAP treatment and treatment use.


Patient education is important to OSA patients' formulation of accurate and realistic disease and treatment perceptions which influence CPAP adherence.

Published by Elsevier Ireland Ltd.

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