Abstract Rationale Positive airway pressure (PAP) is the first-line therapy for all types of sleep apnea; however, adherence remains suboptimal. We evaluated whether a structured, one-hour behavioral education session delivered at the time of consent improves short-term PAP adherence among veterans with sleep apnea by targeting knowledge, skills, motivation, and self-efficacy. Methods A prospective pre-post cohort study conducted within a clinical trial evaluated both short- and long-term changes in adherence to positive airway pressure (PAP) following a structured 1-hour behavioral education session. This intervention combined didactic education on obstructive and central sleep apnea with hands-on device skills, motivational strategies, a brief behavior/mindfulness toolbox, and self-monitoring supported by clinician feedback. Objective adherence metrics were collected from device telemetry and accessed via Care Orchestrator (Philips Respironics) and AirView (ResMed). These metrics included the number of days used, nights with at least 4 hours of use, total usage hours, and average usage per day. The inclusion criteria focused on veterans with sleep apnea who had an AHI 10 events/h and available PAP device telemetry at -120-(-90), -90-(-60), -30-0 (baseline), 0-30, 60-90, and 90-120 days relative to consent. Paired two-tailed t-tests compared baseline data with each follow-up, with significance set at p 0.05. Results The study included 56 male veterans (mean age, 69.5 ± 12.2 years); BMI, 32.8 ± 5.1 kg/m²; AHI, 64.3 ± 27.3 events/h; and CAI, 15.5 ± 13.9 events. In the first month following the educational intervention, statistically significant improvements were observed in multiple adherence domains compared to the 30 days before enrollment. The number of days PAP was used increased (p = 0.01), as did the number of nights with usage of ≥ 4 hours (p = 0.02). Total monthly usage hours rose significantly (p = 0.01), and average usage on days when PAP was used also increased (p = 0.02). At later intervals (30-60 days and 90-120 days post-consent), adherence metrics were not significantly different from pre-intervention values (all p 0.20 except for total usage hours at 90-120 days, p = 0.04), with mean values approximating baseline. Conclusion A single behavioral education session resulted in short-term improvements in PAP adherence; however, these gains were not sustained at follow-up. This pattern indicates that while one-time education may temporarily enhance adherence, additional reinforcement or ongoing support may be necessary to maintain improved use over time. This abstract is funded by: Clinical Science Research and Development (CSR&D) Service
Bawa et al. (Fri,) studied this question.
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