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Controlling sleep apnea all in the mind

September 08, 2005

Sleep apnea patientA researcher from The University of New England has come up with a way to dramatically improve the effectiveness of treatment for sleep apnea, a debilitating - and potentially fatal – sleep disorder that causes sufferers to temporarily stop breathing in their sleep.

UNE honours student Dianne Richards found that by showing a group of sleep apnea patients a video and involving their partners in their treatment she was able to double their compliance with a treatment regime and bring an end to their daytime sleepiness, one of the most common symptoms of the disease. For the study Ms Richards recruited 100 sleep apnea patients from the Royal North Shore Hospital Sleep Investigation Unit, which she manages.

The patients were receiving Continuous Positive Air Pressure (CPAP) treatment, where they were fed a constant stream of compressed air via a mask, keeping their airway open during sleep. CPAP, an Australian invention, is highly effective and can reduce or eliminate the symptoms of sleep apnea when used properly. CPAP therapists, however face a problem: many patients refuse to wear an oxygen mask to bed. Some are worried it will be uncomfortable; others are plain embarrassed.

“It's just not terribly sexy,” Ms Richards said. “Many people are very resistant to having this machine in their bedrooms and that means they're not getting the benefit of the treatment.”

As many as half of all patients who have been prescribed CPAP stop using the machine within the first year, despite the health benefits of the treatment.

Ms Richards decided to look at psychological barriers that were preventing people from sticking with the treatment and ways to overcome them.

She produced a video showing two sleep apnea sufferers talking about CPAP. In the video the two patients talk about the problems they experienced getting started with CPAP, as well as how much better they felt after using it. Finally they exhort other patients to persevere with their treatment, because in the long run “it's worth it”.

Ms Richards showed this video to 50 sleep apnea patients before they began CPAP treatment, and invited them to bring their partners to a discussion about “sleep safety” and the benefits of CPAP.

Patients who watched the video and attended the discussion were more than twice as likely to be using CPAP regularly - and therefore be obtaining a therapeutic benefit - than a control group of 50 patients who did not. After one week of sleeping with the machine only 8 per cent of the patients who had watched the video quit whereas almost half of the patients quit from the control group.

Ms Richards will present the results of her study at the Australian Sleep Association Conference in October. She said her results had important implications for the treatment of sleep apnea and other diseases where psychological factors interfere with a patient's willingness to submit to treatment.

“These results should be of real interest to people in the medical profession, especially those dealing with sleep disorders,” Ms Richards said. “We are very good at diagnosing and treating sleep disorders like sleep apnea, but not so good at dealing with some of the psychological variables that come into play when patients start treatment. This study shows that attending to the psychological variables can contribute to making the treatment effective.”

For more information contact Dianne Richards on (02) 9736 1771 or Leon Braun (UNE Public Relations) on (02) 6773 3771. A photo is available to accompany this story.

Posted by Leon Braun at September 8, 2005 05:59 PM