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Nursing Interventions Improve Continuous Positive Airway Pressure Adherence in Obstructive Sleep Apnea With Excessive Daytime Sleepiness

A Systematic Review

López-López, Laura, PT, MSc1; Torres-Sánchez, Irene, PT, PhD1; Cabrera-Martos, Irene, PT, PhD1; Ortíz-Rubio, Araceli, OT, PhD2; Granados-Santiago, Maria, NP, MSc1; Valenza, Marie Carmen, PT, PhD1

doi: 10.1097/rnj.0000000000000190

Purpose The purpose of this systematic review was to summarize the effectiveness of interventions in the literature to improve adherence to continuous positive airway pressure (CPAP) treatment in patients with excessive daytime sleepiness.

Methods In this review, we considered only randomized controlled trials that included interventions to improve CPAP adherence in adult obstructive sleep apnea (OSA) patients with high daytime sleepiness.

Findings Eight trials were included in this review. The types of interventions to improve adherence to CPAP can be grouped into educational, technological, pharmacological, and multidimensional interventions.

Conclusions and Clinical Relevance Educational programs can increase CPAP adherence in OSA patients. As nurses are the main clinicians responsible for device use for patients, the therapeutic strategies to improve CPAP adherence are important in their clinical setting. Therefore, the nursing work related to the use of CPAP has a great impact on the quality of life and mortality of patients with OSA.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

1 Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain

2 Department of Occupational Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain

Correspondence: Marie Carmen Valenza, Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. De la Ilustración 60, 18016 Granada, Spain. E-mail:

© 2019 Association of Rehabilitation Nurses.