Women’s Experiences with Continuous Positive Air Pressure for Treatment of Obstructive Sleep Apnea: A Qualitative study

Women are less adherent to continuous positive airway pressure (CPAP) treatment than men, but the reasons remain unclear. This study explored women's unique challenges, experiences, and support needs during CPAP initiation and adherence. Semi-structured interviews were conducted with 27 women who initiated CPAP for obstructive sleep apnea (OSA). Questions elicited detailed accounts of their challenges and perceptions of support. Responses were thematically analyzed by two independent reviewers to identify key conceptual categories. Participants initiated CPAP a median of 2 years prior. Mean age was 51 ± 15 years; 29% were Black, 71% White. OSA severity included 40% mild, 21% moderate, 25% severe, and 14% unknown. Three themes emerged: women desired more practical and social support, social and personal factors acted as barriers and facilitators, and persistence and self-advocacy were key to success. Support from durable medical equipment companies, healthcare providers, friends, family, and social media was inconsistent. Women who faced frustration or significant barriers were less successful, while persistence and self-advocacy were critical for those who succeeded. Tailored support addressing women's personal circumstances and motivations may help overcome challenges during CPAP therapy initiation.