Determinants of patient satisfaction in continuous positive airway pressure therapy for obstructive sleep apnea: A multivariate analysis of knowledge, technical, and psychosocial factors

Abstract Background Positive airway pressure (PAP) therapy is the primary treatment for obstructive sleep apnea (OSA), but long-term adherence remains challenging. This study aimed to identify key predictors of patient satisfaction with PAP therapy by examining the interrelationships between disease knowledge, care provision, health beliefs, and patient-reported experiences. Methods A cross-sectional study was conducted at a tertiary sleep center in Germany. Adult patients with confirmed OSA diagnosis and experience with PAP therapy completed a comprehensive questionnaire assessing four domains: health attitudes and self-management, OSA care provision perceptions, OSA disease knowledge, and treatment experience. Multiple regression analysis was performed to identify predictors of treatment satisfaction. Results Among 148 participants (72.8% male, mean age 57.9 ± 11.8 years), 58.8% were active PAP users. High levels of family support (> 90%) and disease knowledge were reported, with 94.4% acknowledging the importance of regular treatment. Treatment experience emerged as the primary predictor of satisfaction in domain-level analysis. The final regression model identified four significant predictors explaining 75.9% of variance in satisfaction: treatment effectiveness (β = 0.304, p <. 001), routine integration (β = 0.286, p =. 001), nocturnal awakening (β = 0.273, p <. 001), and mask removal (β = 0.198, p =. 007). Patient satisfaction negatively correlated with alternative treatment usage (τ=-0.274, p <. 001) and positively with disease duration (τ = 0.187, p =. 008). Conclusion PAP therapy satisfaction is predominantly influenced by treatment-specific factors rather than general health attitudes or care provision perceptions. Understanding these predictors may help clinicians identify patients at risk for low satisfaction and target interventions accordingly.