Soft Styles of Motivating Patients to Adopt CPAP

This chapter reviews “soft” or nonmechanical methods of continuous positive airway pressure (CPAP) adherence in obstructive sleep apnea (OSA). Much of the data are conflicting partly because the studies describe variable OSA populations, but predictive demographic, psychological, and social variables and personality factors and key comorbidities are outlined in a clinically relevant fashion. Decision-making about whether or when to integrate CPAP into the patient’s treatment plan given these factors is discussed. The evidence for behavioral, supportive, and educational interventions for CPAP adherence is summarized with practical implementation strategies. The limited data in children and adolescent CPAP adherence will also be reviewed. Integration of these approaches into telemedicine and emerging technology to improve CPAP adherence will be summarized. This is critical given the current shift in medical service delivery to remote methods of care owing to both the current pandemic and exponential technological growth. The chapter will conclude with models to conceptualize the multifactorial and interactive nature of CPAP adherence.