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 Couples who focused on the benefits for both the patient and the
sleep partner were more likely to use the CPAP machines, the study
authors report in the journal Sleep Health, online July 25.
“Poor adherence to CPAP remains the major impediment to effective
treatment for obstructive sleep apnea,” lead study author Lichuan Ye
of Northeastern University in Boston told Reuters Health.
“Spouses can make a significant difference in their partners’ health
behaviors,” she said by email.
Obstructive sleep apnea, which causes breathing to stop and start
during sleep - often accompanied by loud gasping or snoring -
affects more than 20 million Americans, according to the American
Sleep Apnea Association. CPAP machines are the most common treatment
for OSA but are often seen as bothersome and unattractive.
About 6 in 10 adults sleep with a partner, according to the National
Sleep Foundation, and more than one-fourth of married or
cohabitating couples say their relationships are adversely affected
by sleep problems.
Ye and colleagues interviewed 20 couples to understand how
obstructive sleep apnea affects their relationships and CPAP use.
The interviews focused on the consequences, challenges, questions
and advice that couples had about using CPAP. About two-thirds of
the couples said they slept in the same bed consistently, and
one-quarter said they seldom shared a bed since CPAP use started. On
average, the machine was used five hours per night.
The research team found that partners often helped their spouses
identify sleep problems and go through diagnosis and treatment. The
patients said that if not for their partner, they “would have never
known” they had a problem or would have thought it wasn’t “that
bad.”
It often took repeated discussions and several years before patients
made an appointment to seek help, however. Partners said they were
concerned about their own sleep, as well as the patient’s health.
“Love is blind at first; then, over time, you get tired, and you
have kids,” one partner said. “So every moment I can sleep is
extremely important.”
Although couples expressed anxiety about using the cumbersome
machine at first, those who focused on a sense of “we” when it came
to CPAP use were the most successful. They learned about sleep apnea
and CPAP treatment together. They were better able to have deep
sleep, less worry, less irritability and more energy, as well as
greater intimacy and better communication.
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Several patients said they wouldn’t use a CPAP unless their partner
expressed a concern, and partners often offered help by setting up
the machine, adjusting the mask and helping with maintenance. Verbal
encouragement, such as reminders, compliments and open acceptance of
their partner’s appearance while using the machine, helped as well.
The couples said they wish they had started CPAP treatment sooner
and that being patient with each other while starting the long-term
treatment and adjusting to a new routine were key pieces of advice.
“I found it particularly interesting that some patients reported
using CPAP for their partners’ benefit, and on the flip side,
partners were uncomfortable with this,” said Faith Luyster of the
University of Pittsburgh in Pennsylvania, who wasn't involved in the
study.
“Communication is really the key to making a smooth transition into
using CPAP,” she told Reuters Health by email. “Couples need to talk
about their concerns about the patient starting CPAP, strategize
together, and be respectful and supportive of each other.”
Future studies should also investigate how much spouse involvement
and which aspects play a vital role in CPAP adherence, said Dr.
Salma Batool-Anwar of Harvard Medical School in Boston, who wasn't
involved in the research.
“Sleeping seven to eight hours on a nightly basis is vital for
overall health,” Batool-Anwar told Reuters Health by email.
“Patients should listen to their bed partners’ complaints about
their sleep as early screening, diagnosis, and treatment of sleep
apnea can improve sleep-related quality-of-life.”
SOURCE: http://bit.ly/2w5Z05w
Sleep Health 2017.
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