The Role of Self-Esteem in the Adherence of Patients with Obstructive Sleep Apnea Syndrome to Continuous Positive Airway Pressure Therapy.

Introduction: Continuous positive airway pressure therapy (CPAP) is the gold standard for the treatment of obstructive sleep apnea syndrome (OSAS). This therapy eliminates daytime sleepiness and prevents cardiovascular complications of OSAS. Given that CPAP is a chronic therapy and that in most cases it must be used for life, good adherence to treatment is essential for the patient to feel its benefits. Psychological factors play an important role in the compliance of OSAS patients with CPAP therapy. Self-esteem (SE) can be defined as a person's positive or negative attitude toward the self in totality.

Materials and methods: We conducted a prospective, observational, non-randomized study on an essay of 380 observations with 95 patients. After the evaluation period, based on the average time of CPAP used, the patients were divided into two groups: a first group consisting of 50 patients who were considered adherent to the instituted therapy and a second group comprising 45 patients who were considered non-adherent to the instituted therapy. The aim of this article is to assess the role of self-esteem in the adherence of patients with OSAS to CPAP therapy. Determinants of self-esteem at the beginning of treatment (To) were evaluated. The secondary objectives of the study consisted of investigating the existence of other predictors for the evolution of OSA such as self-esteem and clinical/demographic/paraclinical parameters.

Results: In the present study, the adherence of patients with OSAS to CPAP therapy was 52.63%. The self-esteem score was higher in adherent patients than non-adherent ones. The main factors associated with increased self-esteem levels included good adherence to therapy, education, patient income, absence of alcohol and tobacco consumption, absence of nocturnal symptoms, use of Auto-CPAP, use of nasal mask, absence of other pulmonary pathology, absence of psychological type D.

Conclusions: Psychological factors play an important role in the compliance of OSAS patients with CPAP therapy. Along with other factors, self-esteem may be one of the predictive factors for patients' adherence to CPAP therapy.