Abstract Introduction Obstructive sleep apnea (OSA) can be effectively managed with continuous positive airway pressure (CPAP) therapy. However, adherence and psychosocial outcomes can vary widely between patients. Relationship factors are increasingly recognized as important for treatment success, but the role of relationship duration on CPAP adherence and relational outcomes has not been systematically assessed. We conducted a structured narrative review to evaluate the association of relationship duration with adherence and psychosocial benefit among couples affected by OSA. Methods We reviewed qualitative, observational, and randomized studies published through August 2025 that reported on relationship outcomes in adults with OSA using CPAP and their partners. 26 studies (N = 3384 participants) met the inclusion criteria and were stratified by apnea hypopnea index (AHI: mild, moderate, severe OSA), CPAP adherence (≥4 h/night on ≥70% of nights) and relationship duration (early-term ≤10 years, mid-term 11-20 years, long-term 20 years). Qualitative outcomes were coded for relationship satisfaction, emotional wellbeing, and sexual health, and synthesized in a structured narrative review. Results Across 26 studies, PAP users in long-term relationships exhibited the highest adherence, with 75% meeting adherence criteria, compared to 55% of PAP users in mid-term relationships and less than 50% of PAP users in early-term relationships. Couples in long-term relationships also demonstrated the greatest improvements in relationship satisfaction, communication, and sexual intimacy. Partner engagement, perceived mutual benefit, and baseline relationship quality were found to be the best predictors of adherence. Conclusion Relationship duration appears to be an important determinant of CPAP adherence and psychosocial benefits in OSA. Patients in long-term relationships are more likely to adopt and persist with therapy than those in earlier stages of their relationship. Couples in long-term relationships also show superior relational benefits compared with those in shorter relationships. These findings suggest that relational stability acts as both facilitator of adherence and magnifier of treatment benefit. Behavioral interventions may benefit from tailoring adherence strategies to relationship stage, by integrating partner education and dyadic coping frameworks into sleep apnea management, particularly for couples with shorter relationship duration. Support (if any) Resmed
Ghamedi et al. (Fri,) studied this question.