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Husbands with OSA are more likely to adhere to CPAP if their wives share the bed

April 15, 2008

WESTCHESTER, Ill. - Although continuous positive airway pressure (CPAP) controls a husband's sleep-related obstructive sleep apnea (OSA) symptoms, his treatment adherence is strongly related to his wife sharing the bed, according to a study published in the April 15 issue of the Journal of Clinical Sleep Medicine (JCSM).

The study, authored by Rosalind Cartwright, PhD, of Rush University Medical Center in Chicago, focused on 10 married men with OSA, who slept for two additional nights with their wife, who was not affected with OSA, while both were recorded. The first night included a standard polysomnogram (PSG), or overnight sleep study, without treatment. Following two weeks of home CPAP, the couple returned for a second PSG with the husband on CPAP. During the intervening two weeks, sleep logs were completed daily noting if CPAP was used, the presence of snoring, and where and how well they slept. Adherence data from machine downloads were obtained after an average of 4.6 months.

According to the results, the husband's adherence to CPAP was unrelated to OSA severity, but positively related to the number of nights the couple slept together during the two weeks of home CPAP.

"The study underlines that OSA affects both partners in married couples, and those that diagnose and treat these patients should therefore see them as a unit and include the spouse (partner) in educating them about this disorder and its treatment," said Dr. Cartwright. "When the partner is encouraged to sleep with the patient, he is more likely to continue to wear his CPAP mask than if the partner sleeps separately. CPAP will control the snoring noises and excessive movements that disturb the sleep of both of them, and they both will suffer from excessive daytime sleepiness before he is treated. Those who have separated for sleep before the patient was diagnosed and treated should realize that, if she returns to sharing the bed, the chance of his continuing to use this very successful treatment is 60 percent higher than if she sleeps alone."

OSA is a sleep-related breathing disorder that causes your body to stop breathing during sleep. OSA occurs when the tissue in the back of the throat collapses and blocks the airway. This keeps air from getting into the lungs. It is estimated that four percent of men and two percent of women have OSA, and millions more remain undiagnosed.

On average, most adults need seven to eight hours of nightly sleep to feel alert and well-rested.

The American Academy of Sleep Medicine (AASM) offers the following tips on how to get a good night's sleep:

* Follow a consistent bedtime routine.

* Establish a relaxing setting at bedtime.

* Get a full night's sleep every night.

* Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.

* Do not bring your worries to bed with you.

* Do not go to bed hungry, but don't eat a big meal before bedtime either.

* Avoid any rigorous exercise within six hours of your bedtime.

* Make your bedroom quiet, dark and a little bit cool.

* Get up at the same time every morning.

First introduced as a treatment option for sleep apnea in 1981, CPAP is the most common and effective treatment for OSA. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize sleep apnea and restoring normal oxygen levels.

American Academy of Sleep Medicine