Navigating the Complexities of Obstructive Sleep Apnea: Insights from Patients and Bedpartners on CPAP Therapy and Relationship Dynamics

Obstructive Sleep Apnea (OSA) is a common sleep disorder characterized by repeated interruptions in breathing during sleep, often leading to daytime sleepiness and other complications. Continuous Positive Airway Pressure (CPAP) therapy is a widely used treatment, involving the use of a machine to keep the airways open during sleep. The involvement of bedpartners, typically spouses, in OSA management and CPAP therapy is crucial, as they often witness the effects of the disorder firsthand and play a significant role in treatment adherence. The main aim was to explore OSA patients and bedpartners experience with illness and CPAP therapy. A qualitative study based on Interpretative Phenomenological Analysis (IPA) has been conducted at the Sleep Center of the IRCCS Fondazione Don Gnocchi (Milan). 17 patients who underwent CPAP therapy (Males: 13, 66.58±12.34) and 17 bedpartners (Females: 12, 63.40±10.12) were involved through audio-recorded semi-structured interviews, about themes such as illness perceptions and expectations, risk and protective factors associated with CPAP use and efficacy, and the bedpartner's role in the healthcare journey. Following verbatim transcription of the patients’ interviews, analysis using NVivo software unveiled three superordinate themes, relative themes, and sub-ordinate themes. These include: "Living with a mysterious and invisible illness" highlighting the hidden nature of OSA; "OSA, a shared experience" underscoring the impact of the disorder on both patients and bedpartners; and "A challenging management of CPAP" illustrating the difficulties encountered in CPAP therapy. Similar findings emerged from bedpartners’ interviews. In addition to qualitative data, clinical metrics were collected, including CPAP usage hours/night, the Apnea-Hypopnea Index (AHI), and the duration of CPAP usage in months. Findings underscore the importance of understanding the perspectives of both couple members in coping with OSA and CPAP therapy. By shedding light on the unique challenges faced by patients and bedpartners, healthcare professionals can tailor interventions to enhance treatment adherence and improve overall quality of life. Recognizing the burden of OSA within relationships emphasizes the need for comprehensive support systems and interventions that address the concerns of both individuals. Ultimately, fostering open communication and mutual understanding within OSA couples affected can facilitate better treatment outcomes and long-term adherence to therapy.