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Abstract Introduction Women are less adherent to CPAP than men, but the reasons are unclear. Our goal was to qualitatively explore women’s perceptions of support from their healthcare provider, durable medical equipment (DME) company, and family or friends during the initiation and continuation of CPAP treatment. Methods We conducted 28 semi-structured interviews with women diagnosed with OSA who via self-report were using CPAP every night (n=11), using CPAP intermittently (n=8), or had discontinued use (n=9). The women had mean age ± SD = 51 ± 15, were 29% Black, 71% White, and OSA severity was 40% mild, 21% moderate, 25% severe, 14% unknown. Interview questions were structured to elicit the women’s detailed experiences and perceptions of support while beginning CPAP treatment. Two independent reviewers analyzed responses using a thematic approach that identified the major conceptual categories. Results All the women described overcoming challenges when initiating CPAP treatment, in particular those related to mask fit and discomfort, machine set up, and receiving adequate support when problems arose. In their descriptions of how they solved their challenges, three themes emerged: 1) Self-advocacy was essential, yet many women hesitated to ask for continued support, 2) Tenacity and ‘trial and error’ were crucial to overcoming challenges, 3) Desire for live support including video calls for demonstration of CPAP set up and also general coaching or reinforcement. Women who consistently used CPAP every night, were more likely to discuss overcoming challenges during treatment initiation compared to those who had discontinued its use or were using it intermittently. The consistent CPAP users also discussed receiving support from various sources, particularly their DME company, but also healthcare providers, friends, family, and even Facebook groups; in contrast the women who discontinued its use were less likely to discuss receiving support outside an initial call to their DME. Conclusion Women had to actively pursue support and information that wasn't readily available during initiation and continuation of CPAP treatment, potentially creating a deterrent to its use. Tailored support may be necessary to assist women in overcoming challenges during the initial stages of treatment. Support (if any) University of Pittsburgh, School of Nursing, Center for Research and Evaluation
Morris et al. (Sat,) studied this question.