Impact of illness perceptions on continuous positive airway pressure (CPAP) adherence and couple relationship quality in obstructive sleep apnea (OSA): a cross-sectional study

Background: Obstructive Sleep Apnea (OSA) impacts couple relationship quality between patients and bedpartners. Although Continuous Positive Airway Pressure (CPAP) is recognized as the gold standard treatment, adherence to it poses significant challenges, potentially influenced by illness perceptions (IP). Aims and Objectives: This study aims to investigate the association between CPAP adherence, patients' and bedpartners' IP, and couple relationship quality. Methods: A cross-sectional study is currently underway at the Sleep Center of Fondazione Don Gnocchi (Milan), involving OSA patient-bedpartner dyads, who completed medical and psychological assessments including questionnaires on IP, daytime sleepiness, sleep quality, and relationship quality. Results: The study involved 65 couples with OSA (average AHI=31.20). Patients, remotely monitored (CPAP hours/night: 4.64±2.55), were categorized based on CPAP adaptation stages: 12.3% not yet started, 43.1% within the first year, and 44.6% over a year. Patients' IP of severity decreased with longer adaptation [(t(62)=-2.52, p=.007], with similar trends in bedpartners [(t(62)=-1.71, p=.046]. A negative correlation was found between CPAP usage and patients’ IP (r=-.381; p=.004). However, a positive correlation was noted between patients' and bedpartners' IPs (r=.453; p=.001). Relationship quality improved with longer CPAP adaptation, in both patients [(t(60)=2.19, p=.016] and bedpartners [(t(52)= 2.67, p=.005], but was not significantly correlated with its usage. Conclusions: Considering IP in interventions to enhance CPAP adherence is crucial in OSA management.