ORIGINAL RESEARCH article
Front. Neurol.
Sec. Sleep Disorders
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1604935
This article is part of the Research TopicThe Advance on Sleep Disorder: Mechanisms and InterventionsView all articles
Factors Influencing Adherence to Positive Airway Pressure Therapy in Stroke Patients with Obstructive Sleep Apnea: A Cross-Sectional Study
Provisionally accepted
- 1The Affiliated Hospital of Yangzhou University, Neurology Department, Yangzhou University, Yangzhou 225000, Jiangsu Province, China, Yangzhou University, Yangzhou, China
- 2School of Nursing and School of Public Health, Yangzhou University, Yangzhou, Jiangsu Province, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Pap treatment is the recommended initial approach for moderately severe obstructive sleep apnea patients. Its efficacy is contingent upon patient compliance, yet compliance studies in combined stroke and obstructive sleep apnea (OSA) patients have demonstrated lower rates of compliance, and most of the influencing factors are unregulated. This study aimed to explore shortterm respiratory therapy compliance status among stroke patients with obstructive sleep apnea and identify modifiable influencing factors to improve compliance and create personalized plans.This study was conducted among 254 stroke patients with OSA. Data were collected using standardized questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Epworth 2 Sleepiness Scale (ESS), and Self-Efficacy Measure for Sleep Apnea (SEMSA). Polysomnography (PSG) was used to assess objective sleep parameters. Logistic regression analysis was performed to identify predictors of PAP adherence.The overall compliance rate of stroke patients with OSA was 27.2%, and self-efficacy in patients with stroke combined with OSA (perceived risk (OR=2.23, 95% CI=1.74~2.83), expected effect of treatment (OR=1.23, 95% CI=1.23~1.4), self-assessment (OR=1.17, 95% CI=1.06~1.30), total score on the Health Beliefs Scale (OR=1.20, 95% CI=1.13~1.26)), objective sleep condition (total sleep duration (OR=1.00, 95% CI=1.00~1.01), sleep efficiency (OR=1.00, 95% CI=1.00~1.04)) (OR=1.01, 95% CI=1.00~1.02), N1 phase duration (OR=1.01, 95% CI=1.00~1.01)), OSA severity (AHI (OR=1.04, 95% CI=1.02~1.06)), and longest hypoventilation time (s) (OR=1.02, 95% CI=1.00~1.03), and oxygen desaturation≥3index (ODI) (OR=1.03, 95% CI=1.01~1.05)) were the risk factors affecting their PAP treatment. Conclusion: Patients with stroke combined with OSA have poorer compliance to PAP treatment (27.2%) compared with the general population, and this compliance is closely related to self-efficacy, objective sleep, and the severity of OSA. In the future, we can combine with the Health Belief Models to formulate an individualized intervention plan based on patients' self-efficacy.
Keywords: Cerebral stroke, obstructive sleep apneas, CPAP ventilation, Treatment Adherence, Health belief models
Received: 02 Apr 2025; Accepted: 09 Jun 2025.
Copyright: © 2025 Yu, Xu, Sun, Zheng, Jing, Xu, Tang and Chu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Tie-Yu Tang, The Affiliated Hospital of Yangzhou University, Neurology Department, Yangzhou University, Yangzhou 225000, Jiangsu Province, China, Yangzhou University, Yangzhou, China
Cheng Chu, The Affiliated Hospital of Yangzhou University, Neurology Department, Yangzhou University, Yangzhou 225000, Jiangsu Province, China, Yangzhou University, Yangzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.