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Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea

  1. Dariusz R Wozniak1,*,
  2. Toby J Lasserson2,
  3. Ian Smith1

Editorial Group: Cochrane Airways Group

Published Online: 8 JAN 2014

Assessed as up-to-date: 17 JAN 2013

DOI: 10.1002/14651858.CD007736.pub2


How to Cite

Wozniak DR, Lasserson TJ, Smith I. Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea. Cochrane Database of Systematic Reviews 2014, Issue 1. Art. No.: CD007736. DOI: 10.1002/14651858.CD007736.pub2.

Author Information

  1. 1

    Papworth Hospital, Respiratory Support and Sleep Centre, Cambridge, UK

  2. 2

    The Cochrane Collaboration, Cochrane Editorial Unit, London, UK

*Dariusz R Wozniak, Respiratory Support and Sleep Centre, Papworth Hospital, Papworth Everard, Cambridge, CB23 3RE, UK. darekwozniak@yahoo.co.uk.

Publication History

  1. Publication Status: New search for studies and content updated (conclusions changed)
  2. Published Online: 8 JAN 2014

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[Figure 1]
Figure 1. Study flow diagram.
[Figure 2]
Figure 2. Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
[Figure 3]
Figure 3. Forest plot of comparison: 1 Increased psychological and/or practical support during follow-up + CPAP versus usual care + CPAP, outcome: 1.1 Machine usage (hours/night)—first arm/parallel studies.
[Figure 4]
Figure 4. Forest plot of comparison: 1 Increased practical support and encouragement during follow-up + CPAP versus usual care + CPAP, outcome: 1.3 Machine usage, sensitivity analysis: adherence in control group =< four hours/night.
[Figure 5]
Figure 5. Funnel plot of comparison: 1 Increased practical support and encouragement + CPAP versus usual care + CPAP, outcome: 1.1 Machine usage (hours/night).
[Figure 6]
Figure 6. Forest plot of comparison: 2 Educational interventions + CPAP versus usual care + CPAP, outcome: 2.1 Machine usage (hours/night).
[Figure 7]
Figure 7. Forest plot of comparison: 4 Behavioural therapy + CPAP versus control + CPAP, outcome: 4.1 Machine usage.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Increased practical support and encouragement during follow-up + CPAP versus usual care + CPAP, Outcome 1 Machine usage (hours/night).
[Analysis 1.2]
Analysis 1.2. Comparison 1 Increased practical support and encouragement during follow-up + CPAP versus usual care + CPAP, Outcome 2 Machine usage, sensitivity analysis: excluding participants aware of machine usage monitoring.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Increased practical support and encouragement during follow-up + CPAP versus usual care + CPAP, Outcome 3 Machine usage, sensitivity analysis: adherence in control group < four hours/night.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Increased practical support and encouragement during follow-up + CPAP versus usual care + CPAP, Outcome 4 N deemed adherent (≥ four hours/night).
[Analysis 1.5]
Analysis 1.5. Comparison 1 Increased practical support and encouragement during follow-up + CPAP versus usual care + CPAP, Outcome 5 Epworth Sleepiness Scale scores.
[Analysis 1.6]
Analysis 1.6. Comparison 1 Increased practical support and encouragement during follow-up + CPAP versus usual care + CPAP, Outcome 6 Quality of life: Functional Outcomes of Sleep Questionnaire.
[Analysis 1.7]
Analysis 1.7. Comparison 1 Increased practical support and encouragement during follow-up + CPAP versus usual care + CPAP, Outcome 7 Quality of life: Sleep Apnoea Quality of Life Index (SAQLI).
[Analysis 1.8]
Analysis 1.8. Comparison 1 Increased practical support and encouragement during follow-up + CPAP versus usual care + CPAP, Outcome 8 Mood.
[Analysis 1.9]
Analysis 1.9. Comparison 1 Increased practical support and encouragement during follow-up + CPAP versus usual care + CPAP, Outcome 9 Withdrawals.
[Analysis 1.10]
Analysis 1.10. Comparison 1 Increased practical support and encouragement during follow-up + CPAP versus usual care + CPAP, Outcome 10 AHI on treatment.
[Analysis 1.11]
Analysis 1.11. Comparison 1 Increased practical support and encouragement during follow-up + CPAP versus usual care + CPAP, Outcome 11 Maintenance of Wakefulness Test (MWT).
[Analysis 2.1]
Analysis 2.1. Comparison 2 Educational interventions + CPAP versus usual care + CPAP, Outcome 1 Machine usage (hours/night).
[Analysis 2.2]
Analysis 2.2. Comparison 2 Educational interventions + CPAP versus usual care + CPAP, Outcome 2 N deemed adherent (≥ four hours/night).
[Analysis 2.3]
Analysis 2.3. Comparison 2 Educational interventions + CPAP versus usual care + CPAP, Outcome 3 Epworth Sleepiness Scale scores.
[Analysis 2.4]
Analysis 2.4. Comparison 2 Educational interventions + CPAP versus usual care + CPAP, Outcome 4 Quality of life: Sleep Apnoea Quality of Life Index (SAQLI).
[Analysis 2.5]
Analysis 2.5. Comparison 2 Educational interventions + CPAP versus usual care + CPAP, Outcome 5 HAD Scale for Depression.
[Analysis 2.6]
Analysis 2.6. Comparison 2 Educational interventions + CPAP versus usual care + CPAP, Outcome 6 Withdrawal.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Behavioural therapy + CPAP versus control + CPAP, Outcome 1 Machine usage (hours/night).
[Analysis 3.2]
Analysis 3.2. Comparison 3 Behavioural therapy + CPAP versus control + CPAP, Outcome 2 Sensitivity analysis: excluding participants aware of machine usage monitoring.
[Analysis 3.3]
Analysis 3.3. Comparison 3 Behavioural therapy + CPAP versus control + CPAP, Outcome 3 N deemed adherent (≥ four hours/night).
[Analysis 3.4]
Analysis 3.4. Comparison 3 Behavioural therapy + CPAP versus control + CPAP, Outcome 4 Epworth Sleepiness Scale score.
[Analysis 3.5]
Analysis 3.5. Comparison 3 Behavioural therapy + CPAP versus control + CPAP, Outcome 5 Quality of life: Functional Outcomes of Sleep Questionnaire.
[Analysis 3.6]
Analysis 3.6. Comparison 3 Behavioural therapy + CPAP versus control + CPAP, Outcome 6 Withdrawal.