Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea. However, the success of this treatment is hampered by nonadherence in half of the treated patients. Moreover, in clinical trials, poor adherence reduces adequate exposure required to determine its true effect. There is growing evidence that behavioral interventions, in addition to education, are a promising approach to improving adherence. Behavioral interventions include the use of cognitive behavioral therapy and motivational enhancement therapy designed to elevate a patient's self-efficacy. The abundance of data obtained by CPAP tracking systems enables daily surveillance of use, and this telemonitoring along with telehealth allows the provider to quickly intervene when nightly CPAP use falls below thresholds or mask leaks are present. Telehealth reaches a large number of patients who may not be able to regularly attend a clinic, providing support and reinforcement. Peer support may also be useful in improving adherence. Not all obstructive sleep apnea patients present with the same phenotype, and can, therefore, be clustered into several groupings. Which intervention is most successful with a given phenotype or cluster remains unexplored. Comprehensive adherence management requires a team approach with the unique contribution of different professionals.
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Univ Milano Bicocca, San Gerardo Univ Hosp, Dept Emergency & Intens Care, Monza, Italy
Milan Bicocca Univ, San Gerardo Hosp ASST Monza, Gen Intens Care Unit, Via Pergolesi 33, Monza, MB, ItalyUniv Milano Bicocca, San Gerardo Univ Hosp, Dept Emergency & Intens Care, Monza, Italy
Lucchini, Alberto
Giani, Marco
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Univ Milano Bicocca, San Gerardo Univ Hosp, Dept Emergency & Intens Care, Monza, ItalyUniv Milano Bicocca, San Gerardo Univ Hosp, Dept Emergency & Intens Care, Monza, Italy
Giani, Marco
Minotti, Dario
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Univ Milano Bicocca, San Gerardo Univ Hosp, Dept Emergency & Intens Care, Monza, ItalyUniv Milano Bicocca, San Gerardo Univ Hosp, Dept Emergency & Intens Care, Monza, Italy
Minotti, Dario
Elli, Stefano
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Univ Milano Bicocca, San Gerardo Univ Hosp, Dept Emergency & Intens Care, Monza, ItalyUniv Milano Bicocca, San Gerardo Univ Hosp, Dept Emergency & Intens Care, Monza, Italy