Factors Influencing the Uptake and Use of Continuous Positive Airway Pressure Therapy for Women With Sleep Disordered Breathing

Abstract

The consequences of sleep disordered breathing (SDB) in women are fatigue, morning headaches, insomnia, depression, low functional status, daytime sleepiness, mood disturbances, and poor neuro-behavioural performance. Women appear to be more symptomatic at lower disease severity than men. When CPAP is prescribed, women use it less than men, they reduce their usage within the first week of treatment, and they discontinue it more than men. There is a need to understand the factors influencing CPAP therapy uptake and usage in women to meaningfully address their needs. The purpose of this qualitative evidence synthesis was to identify and synthesize the factors influencing the uptake and use of CPAP in women by conducting a qualitative evidence synthesis guided by the Bargaining and Balancing Life with CPAP theory for content, and the Theoretical Domains Framework for data analysis. Twenty-one studies were included. Barrier domains were Skills, Emotions, Social/Professional Role and Identity, and Beliefs about Capabilities, while facilitator domains were Reinforcement, Social Influences, Goals, and Optimism. Seven themes emerged : 1) Expectations about CPAP, 2) Learning to use my CPAP machine, 3) The burden of the technology, 4) Improvement of SDB symptoms, 5) Not feeling (or looking) like myself, 6) Receiving support, and 7) Choosing my attitude. To ensure appropriate and meaningful SDB care for women, practices must be based on knowledge relevant to women with SDB. Findings from this thesis can inform the design and development of interventions to support women with CPAP therapy uptake and usage. Research on this topic is urgently needed because there was no study eligible with a sample comprised of women only.