Journal of Sleep Disorders & Therapy
Open Access

Abstract

Does Type D personality Increase Perchance for CPAP Non-Adherence in Patients with OSA?

Monika Sharma and Samhita Panda

Introduction: Adherence to Continuous Positive Airway Pressure (CPAP) therapy in patients with Obstructive Sleep Apnea (OSA) has been inconclusively linked to gender, age, disease severity, sleepiness and socioeconomic status. This study aimed to examine the association between distressed personality and CPAP adherence in Indian patients with OSA.

Method: This was a single center, prospective study conducted at a tertiary-care hospital in Delhi, India. Patients diagnosed as OSA by polysomnography (PSG) (and underwent CPAP titration), who completed the questionnaires and returned for follow-up were recruited. Demographic data, clinical and PSG variables were collected. DS14 for Type D personality was administered. Subjects were followed for minimum 30 days of CPAP treatment for adherence verification. Good CPAP compliance was defined as CPAP use >4 hours/night at least 5 days/week.

Result: Sixty-nine patients with OSA (age: 52.23 ± 12.28 years, 76% male) were enrolled. 73% (n=50) had severe OSA while 73.9% had Type D personality (n=51). Although 79.7% (n=55) agreed to CPAP use and 75.4% (n=52) actually initiated therapy, only 43% (n=30) had good CPAP compliance. Therefore, majority (57%, n=39) of patients had poor compliance with CPAP. There was no association between age, gender, marital status and degree of OSA with distressed personality. Interestingly, overall 90% (n=36) of patients having poor acceptance and/or compliance possessed Type D personality as compared to 10% (n=3) non-type D CPAP users (p<0.000).

Conclusion: Distressed personality possibly contributes towards poor CPAP adherence in Indian OSA patients. A multi-dimensional approach including intensive screening for personality profiles, use of patient education and behavior modifications at time of prescription of CPAP may help improve CPAP adherence.