Sleep Breath 2001; 05(1): 013-022
DOI: 10.1055/s-2001-12789

Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Improving Compliance with Nasal CPAP and Vigilance in Older Adults with OSAHS

Mark S. Aloia1 , Lina Di Dio2 , Nora Ilniczky2 , Michael L. Perlis2,3,5 , Donald W. Greenblatt4,5 , Donna E. Giles3,5
  • 1Providence Veterans Administration Medical Center, Brown University School of Medicine, Providence, Rhode Island
  • 2Department of Clinical and Social Psychology, University of Rochester, Rochester, New York
  • 3Department of Psychiatry, University of Rochester, Rochester, New York
  • 4Department of Medicine, University of Rochester, Rochester, New York
  • 5Sleep Disorders Center of Rochester, Rochester, New York
Further Information

Publication History

Publication Date:
31 December 2001 (online)


The present study examined the efficacy of a cognitive-behavioral intervention at improving compliance with CPAP and vigilance in older adults with obstructive sleep apnea/hypopnea syndrome (OSAHS). Participants included 12 subjects who were randomized into one of two groups controlling for age, education, disease severity, and vigilance. The experimental group received two 45-min sessions designed to educate subjects on the consequences of OSAHS and the efficacy of CPAP. The control group received the same extent of therapist contact but did not receive information on OSAHS or CPAP. All subjects were administered a test of vigilance both before and after the study. Compliance data were collected using CPAP devices with internal microprocessors at were read at 1, 4, and 12 weeks after treatment initiation. The results showed that the experimental condition did not enhance compliance after 1 week of treatment but did so by the 12-week follow-up. Subjects in the experimental condition had a run time of 3.2-h per night longer than did those in the control group. Those using CPAP more regularly at 12 weeks also showed greater improvement on vigilance at follow-up. Performance on vigilance testing before the introduction of CPAP was predictive of CPAP use at 12 weeks. In conclusion, a modest cognitive-behavioral intervention may substantially increase CPAP use and vigilance in older adults.


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