Adherence and Effectiveness of Positional Therapy for Obstructive Sleep Apnea Syndrome

Persistent Link:
http://hdl.handle.net/10150/203486
Title:
Adherence and Effectiveness of Positional Therapy for Obstructive Sleep Apnea Syndrome
Author:
Fridel, Keith
Issue Date:
2011
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
The purpose of this investigation was to explore how adherence to a positional therapy intervention affected therapeutic outcome in participants with positional-related obstructive sleep apnea syndrome. Eighteen adult participants identified as having positional-related obstructive sleep apnea by an initial overnight polysomnography study were recruited. Participants were instructed to use a “tennis ball technique” positional device for three weeks at home and record their sleep habits and adherence before a final post-treatment polysomnography evaluation. A repeated measures MANOVA found significant effects of treatment between pre- and post-test on the objective polysomnography variables of Total Recording Time [F(1,17) = 5.21, p<.05, η²=.24], Total Sleep Time [F(1,17) = 8.59, p<.01, η²=.34], Sleep Efficiency [F(1,17) = 5.42, p<.05, η²=.24], Total REM sleep time [F(1,17) = 9.91, p<.01, η²=.37], and the Apnea- Hypopnea Index [F(1,17) = 14.28, p<.001, η²=.46]. Sleep onset latency was not statistically significant. There were significant effects of treatment on the subjective measures of the Functional Outcome of Sleep Quality [F(1,17) = 8.92, p<.01, η²=.35], Pittsburgh Sleep Quality Index [F(1,17) = 11.2, p<.01, η²=..39], Epworth Sleepiness Scale [F(1,17) = 6.69, p<.05, η²=.28], and the Brief Symptom Inventory [F(1,17) = 5.14, p<.05, η²=.23]. No significant interaction effects were found between treatment and adherence when participants were grouped post-hoc into an adherent or non-adherent categories based on their self-reported daily log data. In summary, the results of this study indicated that the positional device was efficacious for significantly improving both objective polysomnography variables and subjective variables of sleep. The results also indicated even partially adherent participants reported significant improvements in nighttime sleep quality and quality of life after the three week treatment period. Mixed Linear Modeling demonstrated that significant improvements in sleep quality, time to sleep onset, and total sleep time were not seen until the last weeks of treatment. This study found very acceptable adherence rates with this positional device design; all participants were able to utilize the therapeutic device on at least a portion of every night during the three-week intervention.
Type:
text; Electronic Dissertation
Keywords:
Intervention; Positional; Sleep; Treatment; Psychology; Adherence; Apnea
Degree Name:
Ph.D.
Degree Level:
doctoral
Degree Program:
Graduate College; Psychology
Degree Grantor:
University of Arizona
Advisor:
Bootzin, Richard R.

Full metadata record

DC FieldValue Language
dc.language.isoenen_US
dc.titleAdherence and Effectiveness of Positional Therapy for Obstructive Sleep Apnea Syndromeen_US
dc.creatorFridel, Keithen_US
dc.contributor.authorFridel, Keithen_US
dc.date.issued2011-
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractThe purpose of this investigation was to explore how adherence to a positional therapy intervention affected therapeutic outcome in participants with positional-related obstructive sleep apnea syndrome. Eighteen adult participants identified as having positional-related obstructive sleep apnea by an initial overnight polysomnography study were recruited. Participants were instructed to use a “tennis ball technique” positional device for three weeks at home and record their sleep habits and adherence before a final post-treatment polysomnography evaluation. A repeated measures MANOVA found significant effects of treatment between pre- and post-test on the objective polysomnography variables of Total Recording Time [F(1,17) = 5.21, p<.05, η²=.24], Total Sleep Time [F(1,17) = 8.59, p<.01, η²=.34], Sleep Efficiency [F(1,17) = 5.42, p<.05, η²=.24], Total REM sleep time [F(1,17) = 9.91, p<.01, η²=.37], and the Apnea- Hypopnea Index [F(1,17) = 14.28, p<.001, η²=.46]. Sleep onset latency was not statistically significant. There were significant effects of treatment on the subjective measures of the Functional Outcome of Sleep Quality [F(1,17) = 8.92, p<.01, η²=.35], Pittsburgh Sleep Quality Index [F(1,17) = 11.2, p<.01, η²=..39], Epworth Sleepiness Scale [F(1,17) = 6.69, p<.05, η²=.28], and the Brief Symptom Inventory [F(1,17) = 5.14, p<.05, η²=.23]. No significant interaction effects were found between treatment and adherence when participants were grouped post-hoc into an adherent or non-adherent categories based on their self-reported daily log data. In summary, the results of this study indicated that the positional device was efficacious for significantly improving both objective polysomnography variables and subjective variables of sleep. The results also indicated even partially adherent participants reported significant improvements in nighttime sleep quality and quality of life after the three week treatment period. Mixed Linear Modeling demonstrated that significant improvements in sleep quality, time to sleep onset, and total sleep time were not seen until the last weeks of treatment. This study found very acceptable adherence rates with this positional device design; all participants were able to utilize the therapeutic device on at least a portion of every night during the three-week intervention.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectInterventionen_US
dc.subjectPositionalen_US
dc.subjectSleepen_US
dc.subjectTreatmenten_US
dc.subjectPsychologyen_US
dc.subjectAdherenceen_US
dc.subjectApneaen_US
thesis.degree.namePh.D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.disciplinePsychologyen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorBootzin, Richard R.en_US
dc.contributor.committeememberArkowitz, Harold S.en_US
dc.contributor.committeememberAllen, John J.B.en_US
dc.contributor.committeememberKazniak, Alfreden_US
dc.contributor.committeememberBootzin, Richard R.en_US
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